| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 1220 W 38th Ave, Denver, Colorado |
| Authorized Official Name and Position | Jessica Mervau (OWNER) |
| Authorized Official Contact | 2699081589 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1220 W 38th Ave Denver CO 80211 Ph: (303) 317-6990 | 1220 W 38th Ave Denver CO 80211 Ph: (303) 317-6990 |
| NPI Number | 1376099002 |
|---|---|
| Provider Enumeration Date | 09/01/2016 |
| Last Update Date | 09/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376099002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 00202605 (Colorado) | Primary |
4th Avenue Family Dentistry, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 390 University Blvd, Denver, CO 80206 Phone: 303-333-0771 Fax: 303-333-0779 | |
Jan B Buckstein Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1660 S Albion St, Suite #718, Denver, CO 80222 Phone: 303-757-7759 Fax: 303-757-1501 | |