Provider Demographics
NPI:1417340308
Name:WOODLAND ENTERPRISES, INC.
Entity Type:Organization
Organization Name:WOODLAND ENTERPRISES, INC.
Other - Org Name:DENTAL HYGIENE ON-SITE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODLAND
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:720-587-9985
Mailing Address - Street 1:4339 GOLF VISTA DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-3528
Mailing Address - Country:US
Mailing Address - Phone:720-587-9985
Mailing Address - Fax:
Practice Address - Street 1:4339 GOLF VISTA DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-3528
Practice Address - Country:US
Practice Address - Phone:720-587-9985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH000905044124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty