| Mountain Stream Dental Care Pllc | |
|
791 W Kelly Rd Woodland Park CO 80863-3014 | |
| (719) 687-9011 | |
| Not Available |
| Full Name | Mountain Stream Dental Care Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 791 W Kelly Rd, Woodland Park, Colorado |
| Authorized Official Name and Position | Leila Macario (GENERAL DENTIST) |
| Authorized Official Contact | 9545999530 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Stream Dental Care Pllc 791 W Kelly Rd Woodland Park CO 80863-3014 Ph: (719) 687-9011 | Mountain Stream Dental Care Pllc 791 W Kelly Rd Woodland Park CO 80863-3014 Ph: (719) 687-9011 |
| NPI Number | 1679204317 |
|---|---|
| Provider Enumeration Date | 06/23/2022 |
| Last Update Date | 06/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679204317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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