Provider Demographics
NPI:1487984118
Name:PERFECT TEETH / WEST 34TH AVENUE P.C.
Entity type:Organization
Organization Name:PERFECT TEETH / WEST 34TH AVENUE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RCM, DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-930-7707
Mailing Address - Street 1:3190 W 34TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3208
Mailing Address - Country:US
Mailing Address - Phone:303-458-3838
Mailing Address - Fax:303-458-1357
Practice Address - Street 1:3190 W 34TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3208
Practice Address - Country:US
Practice Address - Phone:303-458-3838
Practice Address - Fax:303-458-1357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-31
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO55361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty