| Smile Colorado Family Dental | |
|
9101 Pearl St #217 Thornton CO 80229-8022 | |
| (303) 576-9016 | |
| Not Available |
| Full Name | Smile Colorado Family Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 9101 Pearl St #217, Thornton, Colorado |
| Authorized Official Name and Position | Eric M Johnson (OWNER) |
| Authorized Official Contact | 6026970934 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Colorado Family Dental 9101 Pearl St Ste 217 Thornton CO 80229-4353 Ph: (303) 576-9016 | Smile Colorado Family Dental 9101 Pearl St #217 Thornton CO 80229-8022 Ph: (303) 576-9016 |
| NPI Number | 1881101939 |
|---|---|
| Provider Enumeration Date | 01/10/2018 |
| Last Update Date | 01/10/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881101939 | NPI | - | NPPES |
| 9000143289 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 202569 (Colorado) | Primary |
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