Provider Demographics
NPI:1104270883
Name:MOUNTAIN VIEW FAMILY DENTAL WESTMINSTER PLLC
Entity type:Organization
Organization Name:MOUNTAIN VIEW FAMILY DENTAL WESTMINSTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-681-0981
Mailing Address - Street 1:14697 DELAWARE ST # 260B
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80023-9178
Mailing Address - Country:US
Mailing Address - Phone:303-255-1000
Mailing Address - Fax:303-255-1110
Practice Address - Street 1:14697 DELAWARE ST # 260B
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80023-9178
Practice Address - Country:US
Practice Address - Phone:303-255-1000
Practice Address - Fax:303-255-1110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-19
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO99191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty