| South Federal Dental Gp Pc | |
|
1601 So Federal Blvd Suite 201 Denver CO 80219 | |
| (303) 934-0232 | |
| (303) 934-2208 |
| Full Name | South Federal Dental Gp Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1601 So Federal Blvd, Denver, Colorado |
| Authorized Official Name and Position | Dale L Farmer (PRESIDENT) |
| Authorized Official Contact | 3039340232 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Federal Dental Gp Pc 1601 So Federal Blvd Suite 201 Denver CO 80219 Ph: (303) 934-0232 | South Federal Dental Gp Pc 1601 So Federal Blvd Suite 201 Denver CO 80219 Ph: (303) 934-0232 |
| NPI Number | 1386706430 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386706430 | NPI | - | NPPES |
| 04001301 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 105415 (Colorado) | Primary |
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