Provider Demographics
NPI:1922657436
Name:COLORADO AND YALE DENTAL PARTNERS
Entity Type:Organization
Organization Name:COLORADO AND YALE DENTAL PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:CARLSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:303-781-1810
Mailing Address - Street 1:2725 S COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-6601
Mailing Address - Country:US
Mailing Address - Phone:303-781-1810
Mailing Address - Fax:
Practice Address - Street 1:2725 S COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6601
Practice Address - Country:US
Practice Address - Phone:303-781-1810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental