|
| |
|
2617 E 3rd Ave Denver CO 80206-4705 | |
| (303) 225-0525 | |
| (303) 225-0526 |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 2617 E 3rd Ave, Denver, Colorado |
| Authorized Official Name and Position | Damon C Wilkerson (OWNER) |
| Authorized Official Contact | 3032250525 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2617 E 3rd Ave Denver CO 80206-4705 Ph: (303) 225-0525 | 2617 E 3rd Ave Denver CO 80206-4705 Ph: (303) 225-0525 |
| NPI Number | 1164607768 |
|---|---|
| Provider Enumeration Date | 01/02/2008 |
| Last Update Date | 01/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164607768 | NPI | - | NPPES |
| 87656043 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 8281 (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 | |