Healthcare Provider Details

I. General information

NPI: 1215276944
Provider Name (Legal Business Name): SPEAKS ORTHODONTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2013
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3141 N. IRVING ST. STE. 201
DENVER CO
80211
US

IV. Provider business mailing address

2763 KING ST
DENVER CO
80211-4028
US

V. Phone/Fax

Practice location:
  • Phone: 720-496-3335
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number9291
License Number StateCO

VIII. Authorized Official

Name: DR. CLIFTON CORY SPEAKS
Title or Position: MANAGING MEMBER
Credential: D.M.D.
Phone: 720-496-3335