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General NPI Number Information
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NPI Number | 1598481871
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Entity Type | Organization
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Legal Business Name | ELITE DENTAL GROUP WESTMINSTER INC
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Dates
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Enumeration Date | 10/18/2022
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 5068 W 92ND AVE
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City | WESTMINSTER
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State | CO
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Zip | 80031-6302
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Country | US
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Telephone | 303-426-0023
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Fax |
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Provider Business Mailing Address
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Address Line | 5068 W 92ND AVE
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City | WESTMINSTER
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State | CO
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Zip | 80031-6302
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Country | US
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Telephone | 303-426-0023
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | MS. BO NAM
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Credential |
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Telephone | 720-278-8492
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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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