Main Street Dental, Pc | |
6240 S Main St Suite 295 Aurora CO 80016-5376 | |
(303) 627-5460 | |
(303) 627-5438 |
Full Name | Main Street Dental, Pc |
---|---|
Speciality | Dentist |
Location | 6240 S Main St, Aurora, Colorado |
Authorized Official Name and Position | Brian W Langenfeld (DENTIST) |
Authorized Official Contact | 3036275460 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Main Street Dental, Pc 6240 S Main St Suite 295 Aurora CO 80016-5376 Ph: (303) 627-5460 | Main Street Dental, Pc 6240 S Main St Suite 295 Aurora CO 80016-5376 Ph: (303) 627-5460 |
NPI Number | 1659817328 |
---|---|
Provider Enumeration Date | 01/18/2017 |
Last Update Date | 01/18/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659817328 | NPI | - | NPPES |
93222858 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 104888 (Colorado) | Primary |
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