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General NPI Number Information
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NPI Number | 1528341435
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Entity Type | Organization
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Legal Business Name | NICHOLS & SNAVELY PEDIATRIC DENTISTRY, PLLC
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Dates
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Enumeration Date | 09/27/2011
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 4383 TENNYSON ST UNIT 1-F
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City | DENVER
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State | CO
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Zip | 80212-2315
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Country | US
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Telephone | 303-261-7029
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Fax |
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Provider Business Mailing Address
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Address Line | 11201 RODEO CIR
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City | PARKER
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State | CO
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Zip | 80138-7346
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. KELSEY DORINE SNAVELY AKIN
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Credential | DDS
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Telephone | 303-261-7029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 9659
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License Number State | CO
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