| Full Name | |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 2979 Iola St, Denver, Colorado |
| Authorized Official Name and Position | Tyler Dylan Sutton (OFFICE MANAGER) |
| Authorized Official Contact | 7207039116 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2979 Iola St Denver CO 80238-3193 Ph: (720) 703-9116 | 2979 Iola St Denver CO 80238-3193 Ph: (720) 703-9116 |
| NPI Number | 1023829678 |
|---|---|
| Provider Enumeration Date | 01/14/2025 |
| Last Update Date | 01/15/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023829678 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | 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 | |