Provider Demographics
NPI:1710360359
Name:DENVER RESTORATIVE DENTISTRY PLLC
Entity type:Organization
Organization Name:DENVER RESTORATIVE DENTISTRY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LOSLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-427-4120
Mailing Address - Street 1:8181 ARISTA PL UNIT 140
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-7918
Mailing Address - Country:US
Mailing Address - Phone:303-427-4120
Mailing Address - Fax:303-427-4009
Practice Address - Street 1:8181 ARISTA PL UNIT 140
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-7918
Practice Address - Country:US
Practice Address - Phone:303-427-4120
Practice Address - Fax:303-427-4009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-01
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2022671223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty