Provider Demographics
NPI:1508195868
Name:COMFORT DENTAL HIGHLANDS RANCH
Entity Type:Organization
Organization Name:COMFORT DENTAL HIGHLANDS RANCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUIFFO-MORADI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-738-9499
Mailing Address - Street 1:91 W MINERAL AVE
Mailing Address - Street 2:SUITE #150
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120
Mailing Address - Country:US
Mailing Address - Phone:303-738-9499
Mailing Address - Fax:303-738-9540
Practice Address - Street 1:91 W MINERAL AVENUE
Practice Address - Street 2:SUITE #150
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120
Practice Address - Country:US
Practice Address - Phone:303-738-9499
Practice Address - Fax:303-738-9540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-16
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7558122300000X
CO7772122300000X
COLN9906122300000X
CO83521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO11871075Medicaid