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General NPI Number Information
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NPI Number | 1699193466
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Entity Type | Organization
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Legal Business Name | COMPLETE DENTAL SOLUTIONS
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Dates
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Enumeration Date | 03/30/2014
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Last Update Date | 03/30/2014
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Provider Practice Location Address
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Address Line | 413 SUMMIT BLVD SUITE 204
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City | BROOMFIELD
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State | CO
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Zip | 80021-8294
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Country | US
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Telephone | 303-440-3300
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Fax | 877-768-3978
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Provider Business Mailing Address
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Address Line | 413 SUMMIT BLVD SUITE 204
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City | BROOMFIELD
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State | CO
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Zip | 80021-8294
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Country | US
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Telephone | 303-440-3300
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Fax | 877-768-3978
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Authorized Official
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Title or Position | OWNER / DENTIST
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Name | DR. CLIFTON L HARRIS
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Credential | DDS
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Telephone | 434-989-3712
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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 | 10573
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License Number State | CO
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