Provider Demographics
NPI:1134225006
Name:HAMPDEN DENTAL CARE PC
Entity type:Organization
Organization Name:HAMPDEN DENTAL CARE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ANTON
Authorized Official - Last Name:EDLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:303-988-7410
Mailing Address - Street 1:7425 W HAMPDEN AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227
Mailing Address - Country:US
Mailing Address - Phone:303-988-7410
Mailing Address - Fax:303-988-3800
Practice Address - Street 1:7425 W HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227
Practice Address - Country:US
Practice Address - Phone:303-988-7410
Practice Address - Fax:303-988-3800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5134122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty