Provider Demographics
NPI:1740980002
Name:COLORADO DENTAL AFFILIATES, PLLC
Entity type:Organization
Organization Name:COLORADO DENTAL AFFILIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:NARANJA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-431-5830
Mailing Address - Street 1:10135 W 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4003
Mailing Address - Country:US
Mailing Address - Phone:303-431-5830
Mailing Address - Fax:303-431-1324
Practice Address - Street 1:10135 W 38TH AVE
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4003
Practice Address - Country:US
Practice Address - Phone:303-431-5830
Practice Address - Fax:303-431-1324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty