Provider Demographics
NPI:1659574978
Name:AAA FAMILY DENTAL CENTER II PC
Entity Type:Organization
Organization Name:AAA FAMILY DENTAL CENTER II PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT AAA FAMILY DENTAL
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:SCHLAGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-289-3358
Mailing Address - Street 1:3805 NEWTON STREET
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211
Mailing Address - Country:US
Mailing Address - Phone:303-455-0233
Mailing Address - Fax:303-455-9251
Practice Address - Street 1:3805 NEWTON STREET
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211
Practice Address - Country:US
Practice Address - Phone:303-455-0233
Practice Address - Fax:303-455-9251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COHD104342122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1386660520OtherNATIONAL PROVIDER IDENTIF