Provider Demographics
NPI:1427193085
Name:COLORADO DHCA, MIDTOWN, PLLC
Entity type:Organization
Organization Name:COLORADO DHCA, MIDTOWN, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BOBBI
Authorized Official - Middle Name:
Authorized Official - Last Name:SPALLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-832-8655
Mailing Address - Street 1:2005 FRANKLIN ST
Mailing Address - Street 2:SUITE 590, BUILDING 2
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5401
Mailing Address - Country:US
Mailing Address - Phone:303-832-8655
Mailing Address - Fax:303-863-7851
Practice Address - Street 1:2005 FRANKLIN ST
Practice Address - Street 2:SUITE 590, BUILDING 2
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5401
Practice Address - Country:US
Practice Address - Phone:303-832-8655
Practice Address - Fax:303-863-7851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO84152799OtherSPECIALTY