Organization
38TH MODERN DENTAL PRACTICE, LLC
Active
Other names
38th Modern Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT FREDERICK DDS (OWNER)
(303) 515-7008
Entity
Organization
Contact information
Practice address
3550 W 38TH AVE., #5, DENVER, CO 80211
(303) 515-7008
(888) 790-7062
Mailing address
6020 N CAREFREE CIR, COLORADO SPRINGS, CO 80922-2402
(719) 266-2717
(888) 790-7062
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
08/01/2017
Last updated
08/01/2017
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