| On-site Dentist, Llc | |
|
10734 E Berry Ave Englewood CO 80111-3972 | |
| (719) 821-2237 | |
| Not Available |
| Full Name | On-site Dentist, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10734 E Berry Ave, Englewood, Colorado |
| Authorized Official Name and Position | Tyson Pechek (DIRECTOR OF DENTISTRY) |
| Authorized Official Contact | 7198212237 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| On-site Dentist, Llc Po Box 3449 Greenwood Village CO 80155-3449 Ph: () - | On-site Dentist, Llc 10734 E Berry Ave Englewood CO 80111-3972 Ph: (719) 821-2237 |
| NPI Number | 1366960775 |
|---|---|
| Provider Enumeration Date | 09/06/2017 |
| Last Update Date | 10/10/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366960775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 9163 (Colorado) | Primary |
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