|
| |
|
320 E Fontanero St Ste 200 Colorado Springs CO 80907-7525 | |
| (719) 599-0500 | |
| (719) 599-0575 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 320 E Fontanero St Ste 200, Colorado Springs, Colorado |
| Authorized Official Name and Position | Jenny Organista (DIRECTOR OF RCM) |
| Authorized Official Contact | 7193005933 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
320 E Fontanero St Ste 200 Colorado Springs CO 80907-7525 Ph: (719) 599-0500 | 320 E Fontanero St Ste 200 Colorado Springs CO 80907-7525 Ph: (719) 599-0500 |
| NPI Number | 1710763495 |
|---|---|
| Provider Enumeration Date | 09/07/2023 |
| Last Update Date | 09/22/2023 |
| Medicare PECOS PAC ID | 0446790430 |
|---|---|
| Medicare Enrollment ID | O20240905000038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710763495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Matthew D Daddario |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1396923595 PECOS PAC ID: 6103983978 Enrollment ID: I20090323000203 |
| Provider Name | Donald Hull |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1033314497 PECOS PAC ID: 1850565748 Enrollment ID: I20111110000221 |
| Provider Name | Kevin J Wright |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1376863845 PECOS PAC ID: 0042431421 Enrollment ID: I20150211000642 |
| Provider Name | Harry Richard Cole |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1366413361 PECOS PAC ID: 6204068547 Enrollment ID: I20171103000336 |
| Provider Name | John Lydiatt |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1922121383 PECOS PAC ID: 4082154075 Enrollment ID: I20240905000092 |
Craig R. Parlet D.d.s. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1675 Briargate Blvd, Suite B, Colorado Springs, CO 80920 Phone: 719-528-6200 Fax: 719-534-9713 | |
Johnson Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 15435 Gleneagle Dr Ste 210, Colorado Springs, CO 80921 Phone: 719-572-5150 | |
My Local Colorado Dental Practice, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3715 Bloomington St Unit 160, Colorado Springs, CO 80922 Phone: 719-599-0665 | |
Colorado Dental Professionals, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 745 W Baptist Rd, Colorado Springs, CO 80921 Phone: 719-203-7375 | |
Co Specialty Dental Services Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 S Tejon St Ste 200, Colorado Springs, CO 80903 Phone: 719-596-3113 | |
Rand L. Redfern, Dds, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 669 Citadel Dr E, Colorado Springs, CO 80909 Phone: 719-599-9090 Fax: 719-573-9091 | |
Premier Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 685 Citadel Dr E, Suite 302, Colorado Springs, CO 80909 Phone: 719-596-1011 Fax: 719-596-6748 |