Provider Demographics
NPI:1659087963
Name:OPEN AND AFFORDABLE DENTAL LITTLETON WEST PLLC
Entity Type:Organization
Organization Name:OPEN AND AFFORDABLE DENTAL LITTLETON WEST PLLC
Other - Org Name:OPEN AND AFFORDABLE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-280-6584
Mailing Address - Street 1:250 E COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:BENNETT
Mailing Address - State:CO
Mailing Address - Zip Code:80102-8825
Mailing Address - Country:US
Mailing Address - Phone:303-644-5058
Mailing Address - Fax:
Practice Address - Street 1:8370 W COAL MINE AVE STE 106
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-4400
Practice Address - Country:US
Practice Address - Phone:303-569-8177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty