Provider Demographics
NPI:1134466402
Name:FLOSS DENTAL
Entity Type:Organization
Organization Name:FLOSS DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSCHEID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-927-0562
Mailing Address - Street 1:10233 S PARKER RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-9314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10233 S PARKER RD
Practice Address - Street 2:SUITE 203
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-9314
Practice Address - Country:US
Practice Address - Phone:303-927-0562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO84861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty