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General NPI Number Information
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NPI Number | 1154135481
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Entity Type | Organization
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Legal Business Name | DDS ORTHODONTICS PLLC
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 1840 MARKET ST STE B
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City | DENVER
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State | CO
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Zip | 80202-2749
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Country | US
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Telephone | 248-760-4262
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Fax |
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Provider Business Mailing Address
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Address Line | 11765 ASH DR
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City | THORNTON
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State | CO
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Zip | 80233-5114
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DESIREA SCOTT-MOORE
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Credential | DDS
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Telephone | 248-760-4262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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