| Milot Pediatric Dentistry, Llc | |
|
2055 Ken Pratt Blvd Unit B Longmont CO 80501-6554 | |
| (503) 719-3700 | |
| Not Available |
| Full Name | Milot Pediatric Dentistry, Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2055 Ken Pratt Blvd, Longmont, Colorado |
| Authorized Official Name and Position | Jennifer Milot (OWNER/DENTIST) |
| Authorized Official Contact | 5037193700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Milot Pediatric Dentistry, Llc 2851 Shadow Lake Rd Lafayette CO 80026-8970 Ph: (503) 719-3700 | Milot Pediatric Dentistry, Llc 2055 Ken Pratt Blvd Unit B Longmont CO 80501-6554 Ph: (503) 719-3700 |
| NPI Number | 1053768184 |
|---|---|
| Provider Enumeration Date | 05/18/2016 |
| Last Update Date | 11/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053768184 | NPI | - | NPPES |
| 53451767 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 9409 (Colorado) | Primary |
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Ryan Lewis, Dmd, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1325 Hover St Ste 103, Longmont, CO 80501 Phone: 270-293-9194 |