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General NPI Number Information
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NPI Number | 1417840745
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Entity Type | Organization
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Legal Business Name | TEACHING TINY TEETH
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 1500 N GRANT ST STE N
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City | DENVER
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State | CO
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Zip | 80203-1859
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Country | US
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Telephone | 720-336-1715
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Fax |
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Provider Business Mailing Address
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Address Line | 1931 HOLLY OAK WAY
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City | FATE
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State | TX
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Zip | 75087-1229
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Country | US
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Telephone | 407-693-3218
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TASHIKIA RICHARDSON
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Credential | RDH
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Telephone | 440-769-3321
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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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