South Boulder Pediatric Dentistry

LBN: South Boulder Pediatric Dentistry
South Boulder Pediatric Dentistry is an health care organization with primary practice located at 805 S Broadway St Ste 103 , Boulder CO 80305-5972. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. South Boulder Pediatric Dentistry can be contacted via phone (720) 441-2974, or through Graffeo Gardner, Samantha via phone (720) 441-2974.

Contact Information

Primary practice address
805 S Broadway St Ste 103 Boulder CO 80305-5972
Phone: (720) 441-2974
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Graffeo Gardner, Samantha Doctor of Dental Surgery (DDS)
Phone: (720) 441-2974

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X

Profile Details

NPI number 1972287217
LBN Legal business name South Boulder Pediatric Dentistry
DBA Doing business as
Authorized official Graffeo Gardner, Samantha Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 14th, 2023
Last updated Jun 14th, 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.

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