| Southglenn Dental Care, Pc | |
|
6650 S Vine St Ste 200 Centennial CO 80121-2763 | |
| (303) 797-3636 | |
| Not Available |
| Full Name | Southglenn Dental Care, Pc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 6650 S Vine St Ste 200, Centennial, Colorado |
| Authorized Official Name and Position | Angela Eiswerth (CREDENTIALING MANAGER) |
| Authorized Official Contact | 7708330994 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southglenn Dental Care, Pc 7160 Dallas Pkwy Ste 400 Plano TX 75024-7111 Ph: () - | Southglenn Dental Care, Pc 6650 S Vine St Ste 200 Centennial CO 80121-2763 Ph: (303) 797-3636 |
| NPI Number | 1144988957 |
|---|---|
| Provider Enumeration Date | 11/30/2021 |
| Last Update Date | 12/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144988957 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | (* (Not Available)) | Primary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
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