Organization
LEADVILLE DENTAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LANCE A. SCHAMBERGER D.D.S. (OWENER)
(719) 486-2060
Entity
Organization
Contact information
Practice address
733 US HIGHWAY 24, UNIT A, LEADVILLE, CO 80461-3952
(719) 486-2060
Mailing address
733 US HIGHWAY 24, UNIT A, LEADVILLE, CO 80461-3952
(719) 486-2060
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8682
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05972353
—
CO
Enumeration date
05/22/2013
Last updated
05/22/2013
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