Provider Demographics
NPI:1497532170
Name:COLORADO COMFORT KIDS DENTISTRY PLLC
Entity Type:Organization
Organization Name:COLORADO COMFORT KIDS DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHANTRA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-717-9328
Mailing Address - Street 1:9998 W COLFAX AVE UNIT 104
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-3926
Mailing Address - Country:US
Mailing Address - Phone:720-823-4460
Mailing Address - Fax:
Practice Address - Street 1:9998 W COLFAX AVE UNIT 104
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-3926
Practice Address - Country:US
Practice Address - Phone:720-823-4460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty