Provider Demographics
NPI:1982726782
Name:DENTISTRY FOR CHILDREN, PC
Entity type:Organization
Organization Name:DENTISTRY FOR CHILDREN, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AUTUMN
Authorized Official - Middle Name:
Authorized Official - Last Name:HURD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-798-4400
Mailing Address - Street 1:404 EAST MINERAL AVENUE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122
Mailing Address - Country:US
Mailing Address - Phone:303-798-4400
Mailing Address - Fax:303-798-4700
Practice Address - Street 1:404 EAST MINERAL AVENUE
Practice Address - Street 2:SUITE A
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122
Practice Address - Country:US
Practice Address - Phone:303-798-4400
Practice Address - Fax:303-798-4700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO81761223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO94283338Medicaid