Provider Demographics
NPI:1790163004
Name:ASSOCIATED DENTAL PROFESSIONALS
Entity Type:Organization
Organization Name:ASSOCIATED DENTAL PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:WHALEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-232-2929
Mailing Address - Street 1:8015 W ALAMEDA AVE STE 170
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-3042
Mailing Address - Country:US
Mailing Address - Phone:303-232-2929
Mailing Address - Fax:303-232-4707
Practice Address - Street 1:8015 W ALAMEDA AVE STE 170
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3042
Practice Address - Country:US
Practice Address - Phone:303-232-2929
Practice Address - Fax:303-232-4707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO104764261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental