Provider Demographics
NPI:1790185106
Name:STATE BOARD FOR COMMUNITY COLLEGES AND OCCUPATIONAL EDUCATION
Entity Type:Organization
Organization Name:STATE BOARD FOR COMMUNITY COLLEGES AND OCCUPATIONAL EDUCATION
Other - Org Name:COMMUNITY COLLEGE OF DENVER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EVERETTE
Authorized Official - Middle Name:J
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-556-2413
Mailing Address - Street 1:1201 FIFTH ST.
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204
Mailing Address - Country:US
Mailing Address - Phone:303-556-5200
Mailing Address - Fax:303-352-3023
Practice Address - Street 1:1062 AKRON WAY, BLDG. #753
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230
Practice Address - Country:US
Practice Address - Phone:303-365-8338
Practice Address - Fax:303-365-8330
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STATE BOARD FOR COMMUNITY COLLEGES AND OCCUPATIONAL EDUCATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty