Prestige Dental Centers | |
3208 N Academy Blvd Ste 110 Colorado Springs CO 80917-5171 | |
(719) 597-3700 | |
(719) 597-7507 |
Full Name | Prestige Dental Centers |
---|---|
Speciality | Dentist |
Location | 3208 N Academy Blvd Ste 110, Colorado Springs, Colorado |
Authorized Official Name and Position | Diana D Shay (OFFICE MANAGER) |
Authorized Official Contact | 7195973700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Prestige Dental Centers 3208 N Academy Blvd Ste 110 Colorado Springs CO 80917-5171 Ph: (719) 597-3700 | Prestige Dental Centers 3208 N Academy Blvd Ste 110 Colorado Springs CO 80917-5171 Ph: (719) 597-3700 |
NPI Number | 1023412095 |
---|---|
Provider Enumeration Date | 10/20/2014 |
Last Update Date | 10/20/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023412095 | NPI | - | NPPES |
97401862 | Medicaid | CO | |
65426061 | Medicaid | CO | |
38873362 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 7989 (Colorado) | Primary |
122300000X | Dentist | 201875 (Colorado) | Secondary |
124Q00000X | Dental Hygienist | DH000905418 (Colorado) | Secondary |
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