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1407 W 84th Ave Unit B8 Denver CO 80260-4753 | |
(720) 214-4746 | |
(720) 214-4745 |
Full Name | |
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Speciality | Dentist |
Location | 1407 W 84th Ave Unit B8, Denver, Colorado |
Authorized Official Name and Position | Shaun Urbanozo (CREDENTIALING MANAGER) |
Authorized Official Contact | 7193232362 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2221 E Bijou St Ste 100 Colorado Springs CO 80909-8009 Ph: (719) 955-8896 | 1407 W 84th Ave Unit B8 Denver CO 80260-4753 Ph: (720) 214-4746 |
NPI Number | 1972744548 |
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Provider Enumeration Date | 03/11/2009 |
Last Update Date | 10/21/2019 |
Identifier | Type | State | Issuer |
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1972744548 | NPI | - | NPPES |
50132741 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | 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 | |