1942601034 NPI number — G & T ENTERPRISES, P.C.

Table of content: (NPI 1942601034)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942601034 NPI number — G & T ENTERPRISES, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
G & T ENTERPRISES, P.C.
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:
AFFORDABLE DENTAL
Provider Other Organization Name Type Code:
3
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:
1942601034
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3216 HIGH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80205-4062
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-329-0231
Provider Business Mailing Address Fax Number:
303-329-4622

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3216 HIGH 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:
80205-4062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-329-0231
Provider Business Practice Location Address Fax Number:
303-329-4622
Provider Enumeration Date:
09/09/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCCLESKEY
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF OPERATIONS
Authorized Official Telephone Number:
303-521-2560

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1223X0400X , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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