| Cusp Dental Llc | |
|
12101 E 2nd Ave Ste 206 Aurora CO 80011-8328 | |
| (303) 343-2161 | |
| Not Available |
| Full Name | Cusp Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 12101 E 2nd Ave Ste 206, Aurora, Colorado |
| Authorized Official Name and Position | Zachary Hernann (OWNER) |
| Authorized Official Contact | 6309170880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cusp Dental Llc 12101 E 2nd Ave Ste 206 Aurora CO 80011-8328 Ph: () - | Cusp Dental Llc 12101 E 2nd Ave Ste 206 Aurora CO 80011-8328 Ph: (303) 343-2161 |
| NPI Number | 1942715214 |
|---|---|
| Provider Enumeration Date | 12/08/2017 |
| Last Update Date | 12/08/2017 |
| Medicare PECOS PAC ID | 3476813866 |
|---|---|
| Medicare Enrollment ID | O20180202001098 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942715214 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 00203107 (Colorado) | Primary |
| Provider Name | Zachary Hernann |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1225476088 PECOS PAC ID: 4385904770 Enrollment ID: I20180202001170 |
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