| Stonegate Dental, Inc. | |
|
17021 Lincoln Ave Unit B Parker CO 80134-3146 | |
| (720) 851-7069 | |
| Not Available |
| Full Name | Stonegate Dental, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 17021 Lincoln Ave Unit B, Parker, Colorado |
| Authorized Official Name and Position | R. Kelly Petersen (PRESIDENT) |
| Authorized Official Contact | 7208517069 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stonegate Dental, Inc. 17021 Lincoln Ave Unit B Parker CO 80134-3146 Ph: () - | Stonegate Dental, Inc. 17021 Lincoln Ave Unit B Parker CO 80134-3146 Ph: (720) 851-7069 |
| NPI Number | 1902920705 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902920705 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7978 (Colorado) | Primary |
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