| Green Dental | |
|
290 Nickel St Ste 500 Broomfield CO 80020-2129 | |
| (303) 469-5301 | |
| Not Available |
| Full Name | Green Dental |
|---|---|
| Speciality | Dentist |
| Location | 290 Nickel St Ste 500, Broomfield, Colorado |
| Authorized Official Name and Position | Justin Kwon (OWNER) |
| Authorized Official Contact | 3034695301 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Dental 290 Nickel St Ste 500 Broomfield CO 80020-2129 Ph: () - | Green Dental 290 Nickel St Ste 500 Broomfield CO 80020-2129 Ph: (303) 469-5301 |
| NPI Number | 1366918757 |
|---|---|
| Provider Enumeration Date | 10/23/2018 |
| Last Update Date | 11/13/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366918757 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
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