1760099766 NPI number — BELLA NATURAL WOMENS CARE

Table of content: DR. MICHAEL THOMAS BETOR D.D.S. (NPI 1285079806)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760099766 NPI number — BELLA NATURAL WOMENS CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BELLA NATURAL WOMENS CARE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760099766
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
180 E HAMPDEN AVE STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ENGLEWOOD
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80113-2517
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-789-4968
Provider Business Mailing Address Fax Number:
303-789-6018

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3894 OLIVE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80207-1528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-320-8352
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/24/2020

Additional Information

Authorized Official

Authorized Official Last Name:
CHISM
Authorized Official First Name:
DENISE
Authorized Official Middle Name:
MARY
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
303-789-4968

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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