| Southmoor Pediatric Dentistry | |
|
6850 E Hampden Ave Denver CO 80224-3024 | |
| (303) 758-6057 | |
| (303) 692-9655 |
| Full Name | Southmoor Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6850 E Hampden Ave, Denver, Colorado |
| Authorized Official Name and Position | Bradley R. Smith (PRESIDENT) |
| Authorized Official Contact | 3037991872 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southmoor Pediatric Dentistry 6850 E Hampden Ave Denver CO 80224-3024 Ph: (303) 758-6057 | Southmoor Pediatric Dentistry 6850 E Hampden Ave Denver CO 80224-3024 Ph: (303) 758-6057 |
| NPI Number | 1811972094 |
|---|---|
| Provider Enumeration Date | 12/12/2005 |
| Last Update Date | 01/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811972094 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 04949 (Colorado) | Primary |
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