Provider Demographics
NPI:1194832741
Name:HIGHLINE FAMILY DENTRISTRY PC
Entity Type:Organization
Organization Name:HIGHLINE FAMILY DENTRISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-794-6800
Mailing Address - Street 1:2 W DRY CREEK CIR
Mailing Address - Street 2:#125
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120
Mailing Address - Country:US
Mailing Address - Phone:303-794-6800
Mailing Address - Fax:303-794-1148
Practice Address - Street 1:2 W DRY CREEK CIR
Practice Address - Street 2:#125
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120
Practice Address - Country:US
Practice Address - Phone:303-794-6800
Practice Address - Fax:303-794-1148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO84911223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty