Provider Demographics
NPI:1649413030
Name:ALL KIDS DENTAL, P.C.
Entity Type:Organization
Organization Name:ALL KIDS DENTAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:303-670-5437
Mailing Address - Street 1:908 NOB HILL RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-7885
Mailing Address - Country:US
Mailing Address - Phone:303-670-5437
Mailing Address - Fax:
Practice Address - Street 1:908 NOB HILL RD
Practice Address - Street 2:SUITE 300
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-7885
Practice Address - Country:US
Practice Address - Phone:303-670-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO77341223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty