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2861 W 120th Ave Ste 230 Westminster CO 80234-2985 | |
(801) 916-0541 | |
Not Available |
Full Name | |
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Speciality | Dentist - Endodontics |
Location | 2861 W 120th Ave Ste 230, Westminster, Colorado |
Authorized Official Name and Position | Conrad Charles Johnson (MEMBER) |
Authorized Official Contact | 8019160541 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2396 Saint Thomas St New Orleans LA 70130-2059 Ph: (801) 916-0541 | 2861 W 120th Ave Ste 230 Westminster CO 80234-2985 Ph: (801) 916-0541 |
NPI Number | 1124515499 |
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Provider Enumeration Date | 04/21/2018 |
Last Update Date | 04/21/2018 |
Identifier | Type | State | Issuer |
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1124515499 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223E0200X | Dentist - Endodontics | DEN.00203484 (Colorado) | Primary |
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