NPI 1104186501

Family Dentistry

Organisation Public Health or Welfare Agency Denver, CO

Practice location

Address: 1756 Vine St, Denver, CO 80206-1120
Phone: (303) 322-1177
Fax: (303) 322-1199

Authorised official

Name: Collis Johnson
Title: Owner/Dentist
Phone: (303) 322-1177

Registered specialties

Public Health or Welfare Agency Primary

Agencies Taxonomy 251K00000X Licence 104176 (CO)

Other Public Health or Welfare providers in Colorado →

Registry record

NPI: 1104186501
Entity type: Organization
NPI issued: 21 May 2012
Record last updated: 21 May 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.