Provider Demographics
NPI:1023257326
Name:ROBERT D. MADDEN, DDS, MBA, P.C.
Entity type:Organization
Organization Name:ROBERT D. MADDEN, DDS, MBA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:MADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MBA
Authorized Official - Phone:303-973-5859
Mailing Address - Street 1:9200 W CROSS DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-2239
Mailing Address - Country:US
Mailing Address - Phone:303-973-5859
Mailing Address - Fax:
Practice Address - Street 1:9200 W CROSS DR
Practice Address - Street 2:SUITE 300
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-2239
Practice Address - Country:US
Practice Address - Phone:303-973-5859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-10
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1047391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO104739OtherSTATE LICENSE