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General NPI Number Information
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NPI Number | 1205201282
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Entity Type | Organization
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Legal Business Name | BELMAR PARK DENTAL CARE, PC
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Dates
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Enumeration Date | 12/02/2015
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Last Update Date | 12/02/2015
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Provider Practice Location Address
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Address Line | 1555 S WADSWORTH BLVD
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City | LAKEWOOD
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State | CO
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Zip | 80232-6832
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Country | US
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Telephone | 303-986-9522
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Fax | 303-986-1869
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Provider Business Mailing Address
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Address Line | 1555 S WADSWORTH BLVD
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City | LAKEWOOD
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State | CO
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Zip | 80232-6832
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Country | US
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Telephone | 303-986-9522
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Fax | 303-986-1869
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID G COLLINS
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Credential | DDS, FICOI
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Telephone | 303-986-9522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | CO 7064
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License Number State | CO
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