Provider Demographics
NPI:1114145323
Name:D MALCOLM STRANGE DDS PC
Entity Type:Organization
Organization Name:D MALCOLM STRANGE DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:D
Authorized Official - Middle Name:MALCOLM
Authorized Official - Last Name:STRANGE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:303-467-8888
Mailing Address - Street 1:8550 W. 38TH AVE.
Mailing Address - Street 2:SUITE 306
Mailing Address - City:WHEATRIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033
Mailing Address - Country:US
Mailing Address - Phone:303-467-8888
Mailing Address - Fax:303-467-8801
Practice Address - Street 1:8550 W. 38TH AVE.
Practice Address - Street 2:SUITE 306
Practice Address - City:WHEATRIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033
Practice Address - Country:US
Practice Address - Phone:303-467-8888
Practice Address - Fax:303-467-8801
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:D MALCOLM STRANGE DDS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-23
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO06511223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04011771Medicaid