| Captain Smiles Of Greeley Pc | |
|
3485 W 10th St Ste C Greeley CO 80634-5368 | |
| (970) 353-4745 | |
| Not Available |
| Full Name | Captain Smiles Of Greeley Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3485 W 10th St Ste C, Greeley, 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 |
|---|---|
| Captain Smiles Of Greeley Pc 2221 E Bijou St Ste 100 Colorado Springs CO 80909-8009 Ph: (719) 576-1850 | Captain Smiles Of Greeley Pc 3485 W 10th St Ste C Greeley CO 80634-5368 Ph: (970) 353-4745 |
| NPI Number | 1508460387 |
|---|---|
| Provider Enumeration Date | 11/23/2020 |
| Last Update Date | 11/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508460387 | NPI | - | NPPES |
| 35104074 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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