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General NPI Number Information
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NPI Number | 1205799491
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Entity Type | Organization
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Legal Business Name | OPEN AND AFFORDABLE DENTAL CENTENNIAL EAST
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 6726 S REVERE PKWY STE 140
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City | CENTENNIAL
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State | CO
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Zip | 80112-3962
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Country | US
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Telephone | 303-578-6559
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Fax |
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Provider Business Mailing Address
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Address Line | 6726 S REVERE PKWY STE 140
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City | CENTENNIAL
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State | CO
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Zip | 80112-3962
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Country | US
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Telephone | 303-578-6559
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | CARLY WOODS
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Credential |
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Telephone | 720-280-6584
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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 |
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License Number State |
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