Provider Demographics
NPI:1164815841
Name:D. MALCOLM STRANGE DDS, MSD, P.C.
Entity Type:Organization
Organization Name:D. MALCOLM STRANGE DDS, MSD, P.C.
Other - Org Name:PEDIATRIC DENTAL GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MALCOLM
Authorized Official - Last Name:STRANGE
Authorized Official - Suffix:SR
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:80033-4355
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:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4300
Practice Address - Country:US
Practice Address - Phone:303-467-8888
Practice Address - Fax:303-467-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6511223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty