| Lodo Dental Pc | |
|
1435 Wazee St Ste 102 Denver CO 80202-1491 | |
| (303) 623-5636 | |
| (303) 623-5640 |
| Full Name | Lodo Dental Pc |
|---|---|
| Speciality | Dentist |
| Location | 1435 Wazee St Ste 102, Denver, Colorado |
| Authorized Official Name and Position | Nicole Kikue Furuta Griffith (OWNER) |
| Authorized Official Contact | 3036235636 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lodo Dental Pc 1435 Wazee St Ste 102 Denver CO 80202-1491 Ph: (303) 623-5636 | Lodo Dental Pc 1435 Wazee St Ste 102 Denver CO 80202-1491 Ph: (303) 623-5636 |
| NPI Number | 1255543393 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 04/28/2023 |
| Medicare PECOS PAC ID | 1759741937 |
|---|---|
| Medicare Enrollment ID | O20230719002964 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255543393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8980 (Colorado) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
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