Organization
CASCADE MEDICAL AND DENTAL LLC
Active
Other names
Cascade Medical & Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLINTON SCOTT TIMMERMAN DDS (MANAGER)
(206) 818-0769
Entity
Organization
Contact information
Practice address
410 MACON AVE, CANON CITY, CO 81212-3225
(719) 276-0117
Mailing address
807 S DOGWOOD CT, PUEBLO WEST, CO 81007-7564
(206) 818-0769
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DEN.00010745
CO
Other
Enumeration date
06/28/2017
Last updated
07/21/2022
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