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General NPI Number Information
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NPI Number | 1518127422
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Entity Type | Organization
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Legal Business Name | EAST COAST DENTAL, LLC
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Dates
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Enumeration Date | 06/13/2008
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Last Update Date | 08/04/2014
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Provider Practice Location Address
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Address Line | 5200 E COLFAX AVE
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City | DENVER
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State | CO
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Zip | 80220-1304
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Country | US
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Telephone | 303-377-3876
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Fax | 720-941-2920
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Provider Business Mailing Address
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Address Line | 5200 E COLFAX AVE
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City | DENVER
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State | CO
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Zip | 80220-1304
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Country | US
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Telephone | 303-377-3876
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Fax | 720-941-2920
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Authorized Official
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Title or Position | PARTNER/OWNER
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Name | NATALIE IGNATIEFF
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Credential | D.D.S.
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Telephone | 303-377-3876
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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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