Provider Demographics
NPI:1174643084
Name:PERFECT TEETH - BOWMAR P.C.
Entity Type:Organization
Organization Name:PERFECT TEETH - BOWMAR P.C.
Other - Org Name:PERFECT TEETH - BOWMAR P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RCM, DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-930-7707
Mailing Address - Street 1:5050 S FEDERAL BLVD
Mailing Address - Street 2:STE 38
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-6361
Mailing Address - Country:US
Mailing Address - Phone:303-795-1107
Mailing Address - Fax:303-795-1196
Practice Address - Street 1:5050 S FEDERAL BLVD
Practice Address - Street 2:STE 38
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-6361
Practice Address - Country:US
Practice Address - Phone:303-795-1107
Practice Address - Fax:303-795-1196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO60971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty