Provider Demographics
NPI:1568125003
Name:DOCS HEALTH COLORADO, PC
Entity Type:Organization
Organization Name:DOCS HEALTH COLORADO, PC
Other - Org Name:DOCS DENTAL FT.CARSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CREDENTAILING
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:673-625-9382
Mailing Address - Street 1:CHILES AVE
Mailing Address - Street 2:BLDG 1510
Mailing Address - City:FT.CARSON
Mailing Address - State:CO
Mailing Address - Zip Code:80913-4829
Mailing Address - Country:US
Mailing Address - Phone:267-952-7000
Mailing Address - Fax:
Practice Address - Street 1:6097 EASTON RD
Practice Address - Street 2:
Practice Address - City:PIPERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18947-1810
Practice Address - Country:US
Practice Address - Phone:267-927-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-21
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO7516OtherLC LAST 4 LIC #