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General NPI Number Information
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NPI Number | 1386659118
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Entity Type | Organization
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Legal Business Name | FRANC JJ VANDERVEN DMD PC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 10/30/2013
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Provider Practice Location Address
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Address Line | 3333 S WADSWORTH BLVD SUITE D 211
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City | LAKEWOOD
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State | CO
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Zip | 80227
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Country | US
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Telephone | 303-969-9150
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Fax |
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Provider Business Mailing Address
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Address Line | 3333 S WADSWORTH BLVD SUITE D 211
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City | LAKEWOOD
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State | CO
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Zip | 80227
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Country | US
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Telephone | 303-969-9150
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FRANC JJ VANDERVEN
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Credential | DMD
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Telephone | 303-969-9150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 7078
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License Number State | CO
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