Provider Demographics
NPI:1639750151
Name:DR. JUSTIN M. OWENS DDS,PC
Entity Type:Organization
Organization Name:DR. JUSTIN M. OWENS DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-744-1701
Mailing Address - Street 1:10050 W 41ST AVE UNIT 102
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4126
Mailing Address - Country:US
Mailing Address - Phone:303-940-5659
Mailing Address - Fax:
Practice Address - Street 1:10050 W 41ST AVE UNIT 102
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4126
Practice Address - Country:US
Practice Address - Phone:303-940-5659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty