Organization
AAA FAMILY DENTAL CENTER III PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS LOSACCO D.D.S. (PRESIDENT)
(303) 569-3141
Entity
Organization
Contact information
Practice address
801 6TH ST, GEORGETOWN, CO 80444-1022
(303) 569-3141
(303) 569-3041
Mailing address
PO BOX 1022, GEORGETOWN, CO 80444-1022
(303) 569-3141
(303) 569-3041
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
105584
CO
1223G0001X
General Practice Dentistry
105584
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04011847
—
CO
Enumeration date
07/25/2007
Last updated
08/07/2008
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