| Governor's Park Dental Group | |
|
700 E 9th Ave Suite 102 Denver CO 80203-3360 | |
| (303) 832-7789 | |
| (303) 832-0427 |
| Full Name | Governor's Park Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 700 E 9th Ave, Denver, Colorado |
| Authorized Official Name and Position | Terry L Brewick (OWNER) |
| Authorized Official Contact | 3038327789 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Governor's Park Dental Group 700 E 9th Ave Suite 102 Denver CO 80203-3360 Ph: (303) 832-7789 | Governor's Park Dental Group 700 E 9th Ave Suite 102 Denver CO 80203-3360 Ph: (303) 832-7789 |
| NPI Number | 1245256643 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 10/17/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245256643 | NPI | - | NPPES |
| 105046 | Other | CO | COLORADO DENTAL LISC # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 105046 (Colorado) | Primary |
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