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General NPI Number Information
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NPI Number | 1528352101
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Entity Type | Organization
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Legal Business Name | HIGHPOINTE PARK DENTAL, PC
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Dates
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Enumeration Date | 06/01/2011
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Last Update Date | 06/02/2011
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Provider Practice Location Address
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Address Line | 9760 GRANT ST STE 100
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City | THORNTON
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State | CO
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Zip | 80229-2178
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Country | US
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Telephone | 720-583-1425
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Fax | 720-583-1429
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Provider Business Mailing Address
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Address Line | 9760 GRANT ST STE 100
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City | THORNTON
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State | CO
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Zip | 80229-2178
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Country | US
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Telephone | 720-583-1425
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Fax | 720-583-1429
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN LEE HUTCHISON
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Credential | D.D.S.
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Telephone | 720-583-1425
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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 | 9647
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License Number State | CO
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