Healthcare Provider Details

I. General information

NPI: 1225298920
Provider Name (Legal Business Name): HOWARD DENTAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 OGDEN ST
DENVER CO
80218-2892
US

IV. Provider business mailing address

1420 OGDEN STREET
DENVER CO
80218-2892
US

V. Phone/Fax

Practice location:
  • Phone: 303-863-0772
  • Fax: 303-832-7823
Mailing address:
  • Phone: 303-863-0772
  • Fax: 303-832-7823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License NumberDEN10544
License Number StateCO

VIII. Authorized Official

Name: MS. FELICIA L DIAMOND
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 303-863-0772