Provider Demographics
NPI:1184883704
Name:CASTLE ROCK ORTHODONTICS PLLC
Entity type:Organization
Organization Name:CASTLE ROCK ORTHODONTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DUNBAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:303-688-8777
Mailing Address - Street 1:718 MALETA LN
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108-7602
Mailing Address - Country:US
Mailing Address - Phone:303-688-8777
Mailing Address - Fax:303-688-6699
Practice Address - Street 1:718 MALETA LN
Practice Address - Street 2:SUITE 201
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-7602
Practice Address - Country:US
Practice Address - Phone:303-688-8777
Practice Address - Fax:303-688-6699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO77971223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty