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General NPI Number Information
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NPI Number | 1790647410
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Entity Type | Organization
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Legal Business Name | ORTHODONTISTS OF CASTLE ROCK, PLLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 3750 DACORO LN
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City | CASTLE ROCK
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State | CO
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Zip | 80109-2501
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Country | US
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Telephone | 970-691-9694
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Fax |
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Provider Business Mailing Address
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Address Line | 17184 E CEDAR GULCH DR
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City | PARKER
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State | CO
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Zip | 80134-4379
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Country | US
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Telephone | 970-691-9694
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Fax |
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Authorized Official
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Title or Position | OWNER/ORTHODONTIST
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Name | MORGAN LANE
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Credential | DMD, MSD
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Telephone | 970-691-9694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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