Southpark Dental Group Llc | |
3721 Campfire Rd Hartsel CO 80449 | |
(719) 648-2530 | |
Not Available |
Full Name | Southpark Dental Group Llc |
---|---|
Speciality | Dentist - General Practice |
Location | 3721 Campfire Rd, Hartsel, Colorado |
Authorized Official Name and Position | James E Caldwell (OWNER) |
Authorized Official Contact | 7196482530 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Southpark Dental Group Llc 3721 Campfire Rd Hartsel CO 80449-8611 Ph: (719) 648-2530 | Southpark Dental Group Llc 3721 Campfire Rd Hartsel CO 80449 Ph: (719) 648-2530 |
NPI Number | 1861971772 |
---|---|
Provider Enumeration Date | 08/10/2018 |
Last Update Date | 08/20/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1861971772 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |