Provider Demographics
NPI:1295234730
Name:LITTLETON DENTAL STUDIO
Entity type:Organization
Organization Name:LITTLETON DENTAL STUDIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CALE
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:BEASLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-794-1707
Mailing Address - Street 1:3498 E ELLSWORTH AVE UNIT 307
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-2964
Mailing Address - Country:US
Mailing Address - Phone:417-414-4996
Mailing Address - Fax:
Practice Address - Street 1:5622 S DELAWARE ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-5408
Practice Address - Country:US
Practice Address - Phone:303-794-1707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-11
Last Update Date:2018-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental