OrganizationActive
My Local Colorado Dental Practice, LLC
NPI 1811541402 · General Practice Dentistry · Fountain, CO
My Local Colorado Dental Practice, LLC is a General Practice Dentistry organization in Fountain, CO (NPI 1811541402).
Provider details
- NPI number
- 1811541402
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Parent organization
- My Local Colorado Dental Practice, LLC
- Organization subpart
- Yes
- Authorized official
- Michelle Johnson, Credentialing Specialist(509) 315-8338
Practice location
8085 Fountain Mesa Rd
Fountain, CO 80817-1591
Phone: (719) 382-5500
Street-level locationGet directions
Mailing address
8085 Fountain Mesa Rd
Fountain, CO 80817-1591
Registry dates
- Enumerated
- 2019-07-31
- Last updated
- 2019-07-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.