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General NPI Number Information
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NPI Number | 1700663473
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Entity Type | Organization
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Legal Business Name | COLORADO COMFORT KIDS DENTISTRY PLLC
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Dates
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Enumeration Date | 09/14/2023
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 8223 S QUEBEC ST STE O
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City | ENGLEWOOD
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State | CO
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Zip | 80112-3173
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Country | US
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Telephone | 720-343-3668
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Fax |
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Provider Business Mailing Address
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Address Line | 8223 S QUEBEC ST STE O
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City | ENGLEWOOD
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State | CO
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Zip | 80112-3173
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Country | US
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Telephone | 720-343-3668
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CHANTRA NEIT
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Credential |
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Telephone | 720-717-9328
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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 |
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License Number State |
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