Provider Demographics
NPI:1295566677
Name:THE COLORADO ORTHODONTIC FOUNDATION
Entity type:Organization
Organization Name:THE COLORADO ORTHODONTIC FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAILA
Authorized Official - Middle Name:
Authorized Official - Last Name:WERNER BUTTERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-501-3691
Mailing Address - Street 1:PO BOX 8513
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80201-8513
Mailing Address - Country:US
Mailing Address - Phone:303-501-3691
Mailing Address - Fax:720-640-4090
Practice Address - Street 1:7190 COLORADO BLVD STE 300
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-1808
Practice Address - Country:US
Practice Address - Phone:303-501-3691
Practice Address - Fax:720-640-4090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental