Provider Demographics
NPI:1609899038
Name:PEAK FAMILY DENTAL INC.
Entity Type:Organization
Organization Name:PEAK FAMILY DENTAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARLIE
Authorized Official - Middle Name:JOACHIM
Authorized Official - Last Name:BURNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-229-0099
Mailing Address - Street 1:2021 BATTLECREEK DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-5119
Mailing Address - Country:US
Mailing Address - Phone:970-229-0099
Mailing Address - Fax:970-229-1879
Practice Address - Street 1:2021 BATTLECREEK DR
Practice Address - Street 2:SUITE C
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-5119
Practice Address - Country:US
Practice Address - Phone:970-229-0099
Practice Address - Fax:970-229-1879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO81461223G0001X
CO83531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty