Provider Demographics
NPI:1528103181
Name:COLORADO DHCA, CENTER POINTE, PLLC
Entity type:Organization
Organization Name:COLORADO DHCA, CENTER POINTE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-360-0991
Mailing Address - Street 1:14591 E ALAMEDA AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-2601
Mailing Address - Country:US
Mailing Address - Phone:303-360-0991
Mailing Address - Fax:303-364-9522
Practice Address - Street 1:14591 E ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-2601
Practice Address - Country:US
Practice Address - Phone:303-360-0991
Practice Address - Fax:303-364-9522
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