Provider Demographics
NPI:1528354941
Name:ZENON FAMILY & COSMETIC DENTISTRY
Entity type:Organization
Organization Name:ZENON FAMILY & COSMETIC DENTISTRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:CARLTON
Authorized Official - Last Name:ZENON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-307-8282
Mailing Address - Street 1:3471 N SALIDA CT
Mailing Address - Street 2:UNIT 60
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-5020
Mailing Address - Country:US
Mailing Address - Phone:303-307-8282
Mailing Address - Fax:303-307-8181
Practice Address - Street 1:3471 N SALIDA CT
Practice Address - Street 2:UNIT 60
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-5020
Practice Address - Country:US
Practice Address - Phone:303-307-8282
Practice Address - Fax:303-307-8181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO97171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty