Organization · Type 2 NPI

My Local Colorado Dental Practice, LLC

General Practice Dentistry · Boulder, CO

NPI number 1982258653 Active

Practice location

1844 Pearl St
Boulder, CO 80302-5533

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry Primary	1223G0001X	None listed

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

2 other providers at this address

Other general practice dentistry providers in Boulder

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NPI record

NPI: 1982258653
Entity type: Organization (Type 2)
Issued: Jul 30, 2019
Last updated: Jul 30, 2019
Status: Active
Subpart: Yes of My Local Colorado Dental Practice, LLC

Other names

Sage Dental Care · doing business as

Authorized official

Michelle Johnson
Credentialing Specialist
(509) 315-8338

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1982258653

My Local Colorado Dental Practice, LLC's National Provider Identifier is 1982258653, issued on Jul 30, 2019. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Boulder, CO. The record was last updated on Jul 30, 2019.