| Bradley J. Schluter, D.d.s. Inc. | |
|
210 N 19th St Canon City CO 81212-2423 | |
| (719) 275-2454 | |
| Not Available |
| Full Name | Bradley J. Schluter, D.d.s. Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 210 N 19th St, Canon City, Colorado |
| Authorized Official Name and Position | Bradley J. Schluter (OWNER) |
| Authorized Official Contact | 7192752454 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley J. Schluter, D.d.s. Inc. 210 N 19th St Canon City CO 81212-2423 Ph: (719) 275-2454 | Bradley J. Schluter, D.d.s. Inc. 210 N 19th St Canon City CO 81212-2423 Ph: (719) 275-2454 |
| NPI Number | 1356886964 |
|---|---|
| Provider Enumeration Date | 01/05/2017 |
| Last Update Date | 01/05/2017 |
| Medicare PECOS PAC ID | 1153751672 |
|---|---|
| Medicare Enrollment ID | O20200424001474 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356886964 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 10268 (Colorado) | Primary |
| Provider Name | Bradley J Schluter |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1346558368 PECOS PAC ID: 4082906094 Enrollment ID: I20200424001670 |
| Provider Name | Craig S Schluter |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1659383487 PECOS PAC ID: 7618269630 Enrollment ID: I20200424001892 |
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