| Pediatric Sedation Dentistry Of Colorado Pllc | |
|
4027 Boardwalk Dr Fort Collins CO 80525-5938 | |
| (720) 828-2106 | |
| Not Available |
| Full Name | Pediatric Sedation Dentistry Of Colorado Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4027 Boardwalk Dr, Fort Collins, Colorado |
| Authorized Official Name and Position | Matthew Lucero (OWNER) |
| Authorized Official Contact | 7208282106 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Sedation Dentistry Of Colorado Pllc 2755 Eliot St Denver CO 80211-4111 Ph: () - | Pediatric Sedation Dentistry Of Colorado Pllc 4027 Boardwalk Dr Fort Collins CO 80525-5938 Ph: (720) 828-2106 |
| NPI Number | 1841040243 |
|---|---|
| Provider Enumeration Date | 03/26/2024 |
| Last Update Date | 03/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841040243 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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