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General NPI Number Information
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NPI Number | 1730653262
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Entity Type | Organization
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Legal Business Name | KIDS DENTAL FEDERAL PC
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Dates
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Enumeration Date | 01/17/2019
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 2001 W ALAMEDA AVE UNIT D
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City | DENVER
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State | CO
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Zip | 80223-1988
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Country | US
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Telephone | 303-937-7511
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 W ALAMEDA AVE UNIT D
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City | DENVER
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State | CO
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Zip | 80223-1988
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Country | US
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Telephone | 303-937-7511
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | MAGGI EVANS
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Credential |
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Telephone | 720-603-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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