Aaa Family Dental Center Iii Pc | |
801 6th St Georgetown CO 80444-1022 | |
(303) 569-3141 | |
(303) 569-3041 |
Full Name | Aaa Family Dental Center Iii Pc |
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Speciality | Dentist |
Location | 801 6th St, Georgetown, Colorado |
Authorized Official Name and Position | Thomas Losacco (PRESIDENT) |
Authorized Official Contact | 3035693141 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Aaa Family Dental Center Iii Pc Po Box 1022 Georgetown CO 80444-1022 Ph: (303) 569-3141 | Aaa Family Dental Center Iii Pc 801 6th St Georgetown CO 80444-1022 Ph: (303) 569-3141 |
NPI Number | 1376733501 |
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Provider Enumeration Date | 07/25/2007 |
Last Update Date | 08/07/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376733501 | NPI | - | NPPES |
04011847 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 105584 (Colorado) | Primary |
1223G0001X | Dentist - General Practice | 105584 (Colorado) | Secondary |