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General NPI Number Information
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NPI Number | 1992892582
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Entity Type | Organization
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Legal Business Name | COMFORT DENTAL WEST ARVADA
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 14575 WEST 64TH AVE. SUITE A
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City | ARVADA
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State | CO
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Zip | 80004
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Country | US
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Telephone | 303-421-7000
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Fax | 303-421-1687
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Provider Business Mailing Address
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Address Line | 14575 WEST 64TH AVE. SUITE A
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City | ARVADA
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State | CO
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Zip | 80004
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Country | US
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Telephone | 303-421-7000
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Fax | 303-421-1687
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Authorized Official
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Title or Position | DENTIST PARTNER
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Name | JAMES RANDALL MAYO
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Credential |
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Telephone | 303-421-7000
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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 | 7897
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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