Provider Demographics
NPI:1275653073
Name:PERFECT TEETH - ARAPAHOE P.C.
Entity Type:Organization
Organization Name:PERFECT TEETH - ARAPAHOE P.C.
Other - Org Name:PERFECT TEETH - ARAPAHOE P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-285-6098
Mailing Address - Street 1:7600 E ARAPAHOE RD
Mailing Address - Street 2:#311
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1260
Mailing Address - Country:US
Mailing Address - Phone:303-773-2273
Mailing Address - Fax:303-713-9887
Practice Address - Street 1:7600 E ARAPAHOE RD
Practice Address - Street 2:#311
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1260
Practice Address - Country:US
Practice Address - Phone:303-773-2273
Practice Address - Fax:303-713-9887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO60971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty