Provider Demographics
NPI:1225794712
Name:DENVER DENTAL PLLC
Entity Type:Organization
Organization Name:DENVER DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YEVGENIY
Authorized Official - Middle Name:
Authorized Official - Last Name:MONASTYRSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-669-6713
Mailing Address - Street 1:12474 E TENNESSEE CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012
Mailing Address - Country:US
Mailing Address - Phone:303-669-6713
Mailing Address - Fax:
Practice Address - Street 1:6660 E HAMPDEN AVE STE 201
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-3035
Practice Address - Country:US
Practice Address - Phone:303-388-5599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-09
Last Update Date:2021-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty