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1900 16th St Suite 1150 Denver CO 80202-5120 | |
(303) 515-6700 | |
(888) 484-0355 |
Full Name | |
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Speciality | Dentist |
Location | 1900 16th St, Denver, Colorado |
Authorized Official Name and Position | Justin David Moody (OWNER/SOLE MBR) |
Authorized Official Contact | 3035156700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1900 16th St Suite 1150 Denver CO 80202-5120 Ph: (303) 515-6700 | 1900 16th St Suite 1150 Denver CO 80202-5120 Ph: (303) 515-6700 |
NPI Number | 1356686182 |
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Provider Enumeration Date | 12/05/2012 |
Last Update Date | 12/05/2012 |
Identifier | Type | State | Issuer |
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1356686182 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | DEN 9555 (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 | |