Provider Demographics
NPI: | 1871981027 |
---|---|
Name: | COLLEEN S. CARTER DDS, PC |
Entity type: | Organization |
Organization Name: | COLLEEN S. CARTER DDS, PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DDS |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | COLLEEN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CARTER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DDS |
Authorized Official - Phone: | 303-765-2824 |
Mailing Address - Street 1: | 3955 E EXPOSITION AVE |
Mailing Address - Street 2: | SUITE 218 |
Mailing Address - City: | DENVER |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 80209-5000 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 303-765-2824 |
Mailing Address - Fax: | 303-765-2837 |
Practice Address - Street 1: | 3955 E EXPOSITION AVE |
Practice Address - Street 2: | SUITE 218 |
Practice Address - City: | DENVER |
Practice Address - State: | CO |
Practice Address - Zip Code: | 80209-5000 |
Practice Address - Country: | US |
Practice Address - Phone: | 303-765-2824 |
Practice Address - Fax: | 303-765-2837 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-12-22 |
Last Update Date: | 2014-12-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CO | 6740 | 261QD0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QD0000X | Ambulatory Health Care Facilities | Clinic/Center | Dental |