| Elite Dental Group Fountain Inc | |
|
200 Plaza Blvd Fountain CO 80817-2504 | |
| (719) 392-4201 | |
| Not Available |
| Full Name | Elite Dental Group Fountain Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 200 Plaza Blvd, Fountain, Colorado |
| Authorized Official Name and Position | Kyu Hyuk Jung (OWNER) |
| Authorized Official Contact | 7202788492 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Dental Group Fountain Inc 10730 E Bethany Dr Ste 240 Aurora CO 80014-2693 Ph: (720) 278-8492 | Elite Dental Group Fountain Inc 200 Plaza Blvd Fountain CO 80817-2504 Ph: (719) 392-4201 |
| NPI Number | 1275409732 |
|---|---|
| Provider Enumeration Date | 10/13/2025 |
| Last Update Date | 10/13/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275409732 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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