| John S Walkerdmd Prof LLC | |
|
350 Broadway St Ste 120 Boulder CO 80305-3300 | |
| (303) 494-3535 | |
| (303) 494-5095 |
| Full Name | John S Walkerdmd Prof LLC |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 350 Broadway St Ste 120, Boulder, Colorado |
| Authorized Official Name and Position | Christy Galitz (MANAGER) |
| Authorized Official Contact | 3034943535 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John S Walkerdmd Prof LLC 350 Broadway St Ste 120 Boulder CO 80305-3300 Ph: (303) 494-3535 | John S Walkerdmd Prof LLC 350 Broadway St Ste 120 Boulder CO 80305-3300 Ph: (303) 494-3535 |
| NPI Number | 1871915496 |
|---|---|
| Provider Enumeration Date | 01/16/2014 |
| Last Update Date | 01/16/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871915496 | NPI | - | NPPES |
| 2053551 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 105355 (Colorado) | Primary |
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