Provider Demographics
NPI:1942601034
Name:G & T ENTERPRISES, P.C.
Entity Type:Organization
Organization Name:G & T ENTERPRISES, P.C.
Other - Org Name:AFFORDABLE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLESKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-521-2560
Mailing Address - Street 1:3216 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-4062
Mailing Address - Country:US
Mailing Address - Phone:303-329-0231
Mailing Address - Fax:303-329-4622
Practice Address - Street 1:3216 HIGH ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-4062
Practice Address - Country:US
Practice Address - Phone:303-329-0231
Practice Address - Fax:303-329-4622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO122300000X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty