Grin Pediatric Dentistry & Orthodontics Of Centennial
LBN: Pedo Three, Prof. Llc
Grin Pediatric Dentistry & Orthodontics Of Centennial is an health care organization with primary practice located at 6870 S University Blvd , Centennial CO 80122-1515. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is the primary health care specialty.
Pedo Three, Prof. Llc can be contacted via phone (720) 277-5930, or through Flake, Colton via phone (720) 277-5930.
Contact Information
Primary practice address
6870 S University Blvd
Centennial CO 80122-1515
Phone: (720) 277-5930
Fax: (720) 241-7811
Website:
Authorized official contact:
Name: Flake, Colton Doctor of Dental Surgery (DDS)
Phone: (720) 277-5930
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 10630 | Colorado |
| Dental Providers / Pediatric Dentistry | 1223P0221X | 10630 | Colorado |
| Dental Providers / Pediatric Dentistry | 1223P0221X |
Profile Details
| NPI number | 1114166857 |
|---|---|
| LBN Legal business name | Pedo Three, Prof. Llc |
| DBA Doing business as | Grin Pediatric Dentistry & Orthodontics Of Centennial |
| Authorized official | Flake, Colton Doctor of Dental Surgery (DDS) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 18th, 2009 |
| Last updated | Sep 12th, 2023 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114166857 | NPPES |
| Colorado | MEDICAID | 44075871 |
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