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Organization
MOUNTAIN STREAM DENTAL CARE PLLC
Active
Organization
MOUNTAIN STREAM DENTAL CARE PLLC
Active
Other names
Timberland Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEILA MACARIO DMD (GENERAL DENTIST)
(954) 599-9530
Entity
Organization
Contact information
Practice address
791 W KELLY RD, WOODLAND PARK, CO 80863-3014
(719) 687-9011
Mailing address
791 W KELLY RD, WOODLAND PARK, CO 80863-3014
(719) 687-9011
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
NULL
1223G0001X
General Practice Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/23/2022
Last updated
06/23/2022
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