| Pearl Street Dental | |
|
2575 Pearl St Suite 200 Boulder CO 80302-3868 | |
| (303) 443-3177 | |
| (303) 443-3611 |
| Full Name | Pearl Street Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2575 Pearl St, Boulder, Colorado |
| Authorized Official Name and Position | Elliott B Higgins (PRESIDENT) |
| Authorized Official Contact | 3034433771 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pearl Street Dental 2575 Pearl St Suite 200 Boulder CO 80302-3868 Ph: (303) 443-3177 | Pearl Street Dental 2575 Pearl St Suite 200 Boulder CO 80302-3868 Ph: (303) 443-3177 |
| NPI Number | 1609205525 |
|---|---|
| Provider Enumeration Date | 11/01/2013 |
| Last Update Date | 11/01/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609205525 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 124Q00000X | Dental Hygienist | (* (Not Available)) | Secondary |
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