| |
2210 S Federal Blvd Suite 1 Denver CO 80219-5482 | |
(303) 936-5922 | |
(303) 936-5962 |
Full Name | |
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Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 2210 S Federal Blvd, Denver, Colorado |
Authorized Official Name and Position | Yasser W Sedhom (BUSINESS DIRECTOR) |
Authorized Official Contact | 3033440810 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2210 S Federal Blvd Suite 1 Denver CO 80219-5482 Ph: (303) 936-5922 | 2210 S Federal Blvd Suite 1 Denver CO 80219-5482 Ph: (303) 936-5922 |
NPI Number | 1508316902 |
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Provider Enumeration Date | 10/10/2016 |
Last Update Date | 05/09/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508316902 | NPI | - | NPPES |
02066165 | Medicaid | CO | |
34278052 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | 6616 (Colorado) | Primary |
4th Avenue Family Dentistry, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 390 University Blvd, Denver, CO 80206 Phone: 303-333-0771 Fax: 303-333-0779 | |
Jan B Buckstein Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1660 S Albion St, Suite #718, Denver, CO 80222 Phone: 303-757-7759 Fax: 303-757-1501 | |