Provider Demographics
NPI:1447248059
Name:METROPOLITAN DENTAL CARE
Entity type:Organization
Organization Name:METROPOLITAN DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-534-2626
Mailing Address - Street 1:1400 GLENARM PL
Mailing Address - Street 2:#200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-5034
Mailing Address - Country:US
Mailing Address - Phone:303-534-2626
Mailing Address - Fax:303-892-7953
Practice Address - Street 1:1400 GLENARM PL
Practice Address - Street 2:#200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-5034
Practice Address - Country:US
Practice Address - Phone:303-534-2626
Practice Address - Fax:303-892-7953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-07
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO54381223G0001X
CO54511223G0001X
CO73341223G0001X
CO89531223G0001X
CO1062771223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty