Provider Demographics
NPI:1417327784
Name:BIG SKY DENTISTRY, PLLC
Entity Type:Organization
Organization Name:BIG SKY DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-989-4444
Mailing Address - Street 1:325 S TELLER ST
Mailing Address - Street 2:SUITE 280
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-7388
Mailing Address - Country:US
Mailing Address - Phone:303-989-4444
Mailing Address - Fax:720-583-7490
Practice Address - Street 1:325 S TELLER ST
Practice Address - Street 2:SUITE 280
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-7388
Practice Address - Country:US
Practice Address - Phone:303-989-4444
Practice Address - Fax:720-583-7490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-30
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9627261QD0000X
CO10138261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty