| Colorado Dental Team Professional | |
|
10170 Church Ranch Way Unit 110 Westminster CO 80021-6059 | |
| (720) 330-5571 | |
| Not Available |
| Full Name | Colorado Dental Team Professional |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 10170 Church Ranch Way Unit 110, Westminster, Colorado |
| Authorized Official Name and Position | Ketan Sukkawala (OWNER) |
| Authorized Official Contact | 9794501116 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Colorado Dental Team Professional 182 Industrial Rd Glen Rock PA 17327-8626 Ph: (717) 759-4375 | Colorado Dental Team Professional 10170 Church Ranch Way Unit 110 Westminster CO 80021-6059 Ph: (720) 330-5571 |
| NPI Number | 1639847510 |
|---|---|
| Provider Enumeration Date | 09/03/2021 |
| Last Update Date | 03/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639847510 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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