| Mountain Dental Anesthesia Llc | |
|
11001 W 120th Ave Ste 400 Broomfield CO 80021-3493 | |
| (317) 459-0738 | |
| Not Available |
| Full Name | Mountain Dental Anesthesia Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11001 W 120th Ave Ste 400, Broomfield, Colorado |
| Authorized Official Name and Position | John Russell Yancey (DENTIST ANESTHESIOLOGIST) |
| Authorized Official Contact | 3174590738 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Dental Anesthesia Llc 7787 W 106th Ave Westminster CO 80021-3951 Ph: (317) 459-0738 | Mountain Dental Anesthesia Llc 11001 W 120th Ave Ste 400 Broomfield CO 80021-3493 Ph: (317) 459-0738 |
| NPI Number | 1922642743 |
|---|---|
| Provider Enumeration Date | 11/05/2019 |
| Last Update Date | 11/05/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922642743 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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