Provider Demographics
NPI:1588208003
Name:ALOHA DENTAL OF COLORADO P.C
Entity Type:Organization
Organization Name:ALOHA DENTAL OF COLORADO P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-985-8000
Mailing Address - Street 1:2030 E COUNTY LINE RD UNIT K
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-2439
Mailing Address - Country:US
Mailing Address - Phone:303-770-1104
Mailing Address - Fax:
Practice Address - Street 1:2030 E COUNTY LINE RD UNIT K
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-2439
Practice Address - Country:US
Practice Address - Phone:303-770-1104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-29
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1225325558OtherDMD