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General NPI Number Information
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NPI Number | 1720247695
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Entity Type | Organization
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Legal Business Name | AMERICAS CHILDREN DENTAL CLINIC
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 1470 JERSEY ST
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City | DENVER
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State | CO
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Zip | 80220-2652
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Country | US
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Telephone | 303-377-1280
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Fax | 303-400-8262
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Provider Business Mailing Address
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Address Line | 1470 JERSEY ST
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City | DENVER
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State | CO
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Zip | 80220-2652
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Country | US
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Telephone | 303-377-1280
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Fax | 303-400-8262
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | JOHN TRAHAN
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Credential |
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Telephone | 303-377-1280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9303
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License Number State | CO
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