Provider Demographics
NPI:1972836187
Name:DR. DAVID VERLINICH LLC DBA ERIE ORTHODONTICS
Entity Type:Organization
Organization Name:DR. DAVID VERLINICH LLC DBA ERIE ORTHODONTICS
Other - Org Name:ERIE ORTHODONTICS
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:VERLINICH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:720-890-1600
Mailing Address - Street 1:1976 JUNIPER WAY
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-7966
Mailing Address - Country:US
Mailing Address - Phone:720-890-1600
Mailing Address - Fax:720-890-1602
Practice Address - Street 1:615 MITCHELL WAY, SUITE 106
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516
Practice Address - Country:US
Practice Address - Phone:720-890-1600
Practice Address - Fax:720-890-1602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO96161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty