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2020 Wadsworth Blvd Ste 18a Lakewood CO 80214-5730 | |
| (303) 462-1462 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 2020 Wadsworth Blvd Ste 18a, Lakewood, Colorado |
| Authorized Official Name and Position | Charlotte Dasch (DIRECTOR OF PROVIDER RELATIONS) |
| Authorized Official Contact | 5046380303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1610 54th Ave N Ste 205 Nashville TN 37209-1442 Ph: () - | 2020 Wadsworth Blvd Ste 18a Lakewood CO 80214-5730 Ph: (303) 462-1462 |
| NPI Number | 1982346375 |
|---|---|
| Provider Enumeration Date | 04/07/2022 |
| Last Update Date | 02/04/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982346375 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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