Provider Demographics
NPI:1770962243
Name:JAY CRAIG PINKNER DDS PC
Entity type:Organization
Organization Name:JAY CRAIG PINKNER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:PINKNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-442-1481
Mailing Address - Street 1:1361 FRANCIS STREET
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501
Mailing Address - Country:US
Mailing Address - Phone:303-776-0117
Mailing Address - Fax:
Practice Address - Street 1:1361 FRANCIS STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501
Practice Address - Country:US
Practice Address - Phone:303-776-0117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8268332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment