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6620 Camden Blvd Fountain CO 80817-2505 | |
| (719) 631-6649 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 6620 Camden Blvd, Fountain, Colorado |
| Authorized Official Name and Position | Warren Johnson (PRESIDENT) |
| Authorized Official Contact | 7194329807 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5850 Tutt Center Pt Ste 100 Colorado Springs CO 80922-3520 Ph: (719) 596-3081 | 6620 Camden Blvd Fountain CO 80817-2505 Ph: (719) 631-6649 |
| NPI Number | 1477188407 |
|---|---|
| Provider Enumeration Date | 03/10/2020 |
| Last Update Date | 08/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477188407 | NPI | - | NPPES |
| 1223X0400X | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
Just For Grins Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6436 S Us Highway 85-87, Suite C, Fountain, CO 80817 Phone: 719-392-5111 Fax: 719-392-4143 | |
New Beginnings Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 320 S Santa Fe Ave, Suite B, Fountain, CO 80817 Phone: 719-391-4373 Fax: 719-391-9084 | |
Imagine Kids Dentistry Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6620 Camden Blvd, Fountain, CO 80817 Phone: 719-722-4999 | |
Johnson And Associates Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Plaza Blvd, Fountain, CO 80817 Phone: 719-392-4201 Fax: 719-391-7873 |