|
| |
|
5055 E Kentucky Ave Denver CO 80246 | |
| (303) 757-8844 | |
| (303) 759-0994 |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 5055 E Kentucky Ave, Denver, Colorado |
| Authorized Official Name and Position | David Joel Hayutin (MANAGER) |
| Authorized Official Contact | 3037578844 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5055 E Kentucky Ave Denver CO 80246 Ph: (303) 757-8844 | 5055 E Kentucky Ave Denver CO 80246 Ph: (303) 757-8844 |
| NPI Number | 1649271198 |
|---|---|
| Provider Enumeration Date | 08/09/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649271198 | NPI | - | NPPES |
| 83874330 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 6181 (Colorado) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | 915 (Wyoming) | Secondary |
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 | |