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90 Madison St Suite 406 Denver CO 80206-5418 | |
(303) 393-6006 | |
(303) 377-5173 |
Full Name | |
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Speciality | Dentist |
Location | 90 Madison St, Denver, Colorado |
Authorized Official Name and Position | Gary Edward Hagen (OWNER) |
Authorized Official Contact | 3033936006 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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90 Madison St Suite 406 Denver CO 80206-5418 Ph: (303) 393-6006 | 90 Madison St Suite 406 Denver CO 80206-5418 Ph: (303) 393-6006 |
NPI Number | 1073819884 |
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Provider Enumeration Date | 01/27/2011 |
Last Update Date | 03/21/2011 |
Identifier | Type | State | Issuer |
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1073819884 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 104680 (Colorado) | Primary |
4th Avenue Family Dentistry, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 390 University Blvd, Denver, CO 80206 Phone: 303-333-0771 Fax: 303-333-0779 | |
Jan B Buckstein Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1660 S Albion St, Suite #718, Denver, CO 80222 Phone: 303-757-7759 Fax: 303-757-1501 | |