Provider Demographics
NPI:1417392242
Name:GALEN T CALLENDER DDS PC
Entity Type:Organization
Organization Name:GALEN T CALLENDER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GALEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:CALLENDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-973-7771
Mailing Address - Street 1:6169 S. BALSAM WAY
Mailing Address - Street 2:SUITE 380
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-3088
Mailing Address - Country:US
Mailing Address - Phone:303-973-7771
Mailing Address - Fax:
Practice Address - Street 1:6169 S BALSAM WAY
Practice Address - Street 2:SUITE 380
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-3062
Practice Address - Country:US
Practice Address - Phone:303-973-7771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1047971223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty