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1525 Raleigh St Ste 130 Denver CO 80204 | |
| (281) 755-8737 | |
| (866) 892-0774 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1525 Raleigh St, Denver, Colorado |
| Authorized Official Name and Position | David Wayne Bryant (OWNER) |
| Authorized Official Contact | 4617558737 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1525 Raleigh St Ste 130 Denver CO 80204 Ph: (281) 755-8737 | 1525 Raleigh St Ste 130 Denver CO 80204 Ph: (281) 755-8737 |
| NPI Number | 1932658853 |
|---|---|
| Provider Enumeration Date | 10/04/2016 |
| Last Update Date | 10/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932658853 | NPI | - | NPPES |
| 1528329752 | Other | CO | NPI TYPE 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DEN.00010632 (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 | |