Provider Demographics
NPI:1093249476
Name:ASK DENTAL CORP
Entity Type:Organization
Organization Name:ASK DENTAL CORP
Other - Org Name:ONE ON ONE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEONGRYEOL
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-758-9511
Mailing Address - Street 1:7150 E HAMPDEN AVE
Mailing Address - Street 2:STE 104
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-3025
Mailing Address - Country:US
Mailing Address - Phone:303-758-9511
Mailing Address - Fax:
Practice Address - Street 1:7150 E HAMPDEN AVE
Practice Address - Street 2:STE 104
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-3025
Practice Address - Country:US
Practice Address - Phone:303-758-9511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN 00202864122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO18250068Medicaid