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1050 W Colfax Ave Suite G Denver CO 80204-2072 | |
| (303) 573-5533 | |
| (303) 573-5539 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 1050 W Colfax Ave, Denver, Colorado |
| Authorized Official Name and Position | Kelly Kendall White (OWNER) |
| Authorized Official Contact | 3035735533 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1050 W Colfax Ave Suite G Denver CO 80204-2072 Ph: (303) 573-5533 | 1050 W Colfax Ave Suite G Denver CO 80204-2072 Ph: (303) 573-5533 |
| NPI Number | 1952847485 |
|---|---|
| Provider Enumeration Date | 01/08/2017 |
| Last Update Date | 01/08/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952847485 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DEN.00104752 (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 | |