| Patra Watana Dmd Pediatric Dentistry Llc | |
|
8200 E. Belleview Ave. Suite #420e Greenwood Village CO 80111 | |
| (303) 740-7088 | |
| Not Available |
| Full Name | Patra Watana Dmd Pediatric Dentistry Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 8200 E. Belleview Ave., Greenwood Village, Colorado |
| Authorized Official Name and Position | Patra Watana (OWNER) |
| Authorized Official Contact | 3037407088 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Patra Watana Dmd Pediatric Dentistry Llc 8200 E Belleview Ave Suite #420e Greenwood Village CO 80111-2803 Ph: (303) 740-7088 | Patra Watana Dmd Pediatric Dentistry Llc 8200 E. Belleview Ave. Suite #420e Greenwood Village CO 80111 Ph: (303) 740-7088 |
| NPI Number | 1093121667 |
|---|---|
| Provider Enumeration Date | 07/03/2014 |
| Last Update Date | 07/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093121667 | NPI | - | NPPES |
| 02123371 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 6614 (Colorado) | Primary |
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