Provider Demographics
NPI:1497447312
Name:DL DENTAL PLLC
Entity Type:Organization
Organization Name:DL DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-935-3574
Mailing Address - Street 1:325 S TELLER ST STE 290
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-7389
Mailing Address - Country:US
Mailing Address - Phone:470-269-9399
Mailing Address - Fax:
Practice Address - Street 1:325 S TELLER ST STE 290
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-7389
Practice Address - Country:US
Practice Address - Phone:470-269-9399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental