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General NPI Number Information
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NPI Number | 1972320653
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Entity Type | Organization
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Legal Business Name | SOTOODEH DENTAL, PLLC
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Dates
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Enumeration Date | 09/24/2024
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 9200 W CROSS DR STE 300
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City | LITTLETON
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State | CO
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Zip | 80123-2238
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Country | US
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Telephone | 303-973-5859
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Fax |
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Provider Business Mailing Address
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Address Line | 1633 N PEARL ST APT 539
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City | DENVER
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State | CO
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Zip | 80203-1650
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Country | US
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Telephone | 719-434-0772
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | AREZOO SOTOODEH
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Credential |
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Telephone | 719-434-0772
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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 |
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License Number State |
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