Provider Demographics
NPI:1104285261
Name:FAMILY DENTAL AND ORAL HYGIENE OF COLORADO INC
Entity type:Organization
Organization Name:FAMILY DENTAL AND ORAL HYGIENE OF COLORADO INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERENI
Authorized Official - Middle Name:MAIA
Authorized Official - Last Name:BIELFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:303-359-5677
Mailing Address - Street 1:9227 E. LINCOLN AVE. SUITE 200
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124
Mailing Address - Country:US
Mailing Address - Phone:303-359-5677
Mailing Address - Fax:
Practice Address - Street 1:9227 E. LINCOLN AVE. SUITE 200
Practice Address - Street 2:SUITE 200
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124
Practice Address - Country:US
Practice Address - Phone:303-359-5677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-17
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH002023775261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental