Organization
WASATCH PAYROLL LLC
Active
Other names
Four Seasons Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADY SEFCIK (DDS)
(719) 383-2083
Entity
Organization
Contact information
Practice address
2753 JANITELL RD, COLORADO SPRINGS, CO 80906-4102
(719) 383-2083
(719) 383-2047
Mailing address
2753 JANITELL RD, COLORADO SPRINGS, CO 80906-4102
(719) 383-2083
(719) 383-2047
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03889262
—
CO
05
—
28132742
—
CO
05
—
75276062
—
CO
Enumeration date
10/21/2015
Last updated
12/09/2015
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