| Co Specialty Dental Services, Pllc | |
|
1140 W S Boulder Rd Ste 102 Lafayette CO 80026-8910 | |
| (303) 604-9500 | |
| Not Available |
| Full Name | Co Specialty Dental Services, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1140 W S Boulder Rd Ste 102, Lafayette, Colorado |
| Authorized Official Name and Position | Charlotte Dasch (DIRECTOR OF CREDENTIALING AND PR) |
| Authorized Official Contact | 5046380303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Co Specialty Dental Services, Pllc 1610 54th Ave N Ste 205 Nashville TN 37209-1442 Ph: (615) 678-0759 | Co Specialty Dental Services, Pllc 1140 W S Boulder Rd Ste 102 Lafayette CO 80026-8910 Ph: (303) 604-9500 |
| NPI Number | 1649016627 |
|---|---|
| Provider Enumeration Date | 07/08/2024 |
| Last Update Date | 07/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649016627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Secondary |
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