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General NPI Number Information
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NPI Number | 1467845834
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Entity Type | Organization
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Legal Business Name | SALIDA SMILES
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Dates
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Enumeration Date | 03/10/2015
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Last Update Date | 03/10/2015
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Provider Practice Location Address
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Address Line | 3464 N. SALIDA ST. UNIT B
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City | AURORA
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State | CO
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Zip | 80011
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Country | US
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Telephone | 303-307-4471
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Fax | 303-307-9999
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Provider Business Mailing Address
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Address Line | 3471 N SALIDA CT SUITE 40
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City | AURORA
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State | CO
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Zip | 80011-5020
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Country | US
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Telephone | 303-307-9999
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Fax | 303-307-9992
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Authorized Official
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Title or Position | DENTIST/ OWNER
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Name | DR. ANDRE GILLESPIE
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Credential |
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Telephone | 303-307-9999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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