Healthcare Provider Details

I. General information

NPI: 1477756401
Provider Name (Legal Business Name): GALEN THORNTON CALLENDER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 04/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6169 S BALSAM WAY SUITE 380
LITTLETON CO
80123-3062
US

IV. Provider business mailing address

6169 S BALSAM WAY SUITE 380
LITTLETON CO
80123-3062
US

V. Phone/Fax

Practice location:
  • Phone: 303-973-7771
  • Fax: 303-973-5616
Mailing address:
  • Phone: 303-973-7771
  • Fax: 303-973-5616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number104797
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: