Provider Demographics
NPI:1891756581
Name:FAMILY FIRST DENTAL PC
Entity type:Organization
Organization Name:FAMILY FIRST DENTAL PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:GRYZICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-693-9600
Mailing Address - Street 1:6040 S GUN CLUB RD
Mailing Address - Street 2:STE G3 FAMILY FIRST DENTAL
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016
Mailing Address - Country:US
Mailing Address - Phone:303-693-9600
Mailing Address - Fax:303-693-9601
Practice Address - Street 1:6040 S GUN CLUB RD
Practice Address - Street 2:STE G3 FAMILY FIRST DENTAL
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016
Practice Address - Country:US
Practice Address - Phone:303-693-9600
Practice Address - Fax:303-693-9601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO74181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty