| Russell L. Casement, Dds | |
|
1355 S Colorado Blvd Ste 320 Denver CO 80222-3316 | |
| (303) 758-0866 | |
| (303) 758-3657 |
| Full Name | Russell L. Casement, Dds |
|---|---|
| Speciality | Dentist |
| Location | 1355 S Colorado Blvd Ste 320, Denver, Colorado |
| Authorized Official Name and Position | Russell L Casement (PRESIDENT) |
| Authorized Official Contact | 3037580866 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Russell L. Casement, Dds 1355 S Colorado Blvd Ste 320 Denver CO 80222-3316 Ph: (303) 758-0866 | Russell L. Casement, Dds 1355 S Colorado Blvd Ste 320 Denver CO 80222-3316 Ph: (303) 758-0866 |
| NPI Number | 1447576749 |
|---|---|
| Provider Enumeration Date | 04/12/2010 |
| Last Update Date | 04/12/2010 |
| Medicare PECOS PAC ID | 4385917236 |
|---|---|
| Medicare Enrollment ID | O20170829001869 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447576749 | NPI | - | NPPES |
| 1679575740 | Other | CO | INDIVIDUAL NPI |
| 1083619035 | Other | CO | INDIVIDUAL NPI |
| 02036747 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3674 (Colorado) | Primary |
| 1223G0001X | Dentist - General Practice | 8658 (Colorado) | Secondary |
| Provider Name | Kelley A Casement |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1083619035 PECOS PAC ID: 9931415197 Enrollment ID: I20170829002675 |
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