Provider Demographics
NPI:1801827829
Name:NORTH WESTMINSTER DENTAL PARTNERS, LLP
Entity Type:Organization
Organization Name:NORTH WESTMINSTER DENTAL PARTNERS, LLP
Other - Org Name:COMFORT DENTAL NORTH WESTMINSTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDRIC
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOHL
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-469-2333
Mailing Address - Street 1:11187 SHERIDAN BLVD
Mailing Address - Street 2:UNIT 12
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80020-3231
Mailing Address - Country:US
Mailing Address - Phone:303-469-2333
Mailing Address - Fax:303-469-2011
Practice Address - Street 1:11187 SHERIDAN BLVD
Practice Address - Street 2:UNIT 12
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80020-3231
Practice Address - Country:US
Practice Address - Phone:303-469-2333
Practice Address - Fax:303-469-2011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04023529Medicaid