Provider Demographics
NPI:1043813462
Name:CASTLE ROCK KIDS' DENTISTRY
Entity Type:Organization
Organization Name:CASTLE ROCK KIDS' DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:OTOOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-814-1335
Mailing Address - Street 1:2352 MEADOWS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-8408
Mailing Address - Country:US
Mailing Address - Phone:303-814-1335
Mailing Address - Fax:
Practice Address - Street 1:2352 MEADOWS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-8408
Practice Address - Country:US
Practice Address - Phone:303-814-1335
Practice Address - Fax:720-733-7561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty