Provider Demographics
NPI:1285161760
Name:KANTOR DENTAL GROUP PLLC
Entity type:Organization
Organization Name:KANTOR DENTAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARSIAGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-787-4970
Mailing Address - Street 1:4760 W MINERAL AVE STE 60
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-2540
Mailing Address - Country:US
Mailing Address - Phone:720-222-2345
Mailing Address - Fax:
Practice Address - Street 1:4760 W MINERAL AVE STE 60
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-2540
Practice Address - Country:US
Practice Address - Phone:720-222-2345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-16
Last Update Date:2017-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization