| Southpark Dental Group Llc | |
|
3721 Campfire Rd Hartsel CO 80449 | |
| (719) 648-2530 | |
| Not Available |
| Full Name | Southpark Dental Group Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3721 Campfire Rd, Hartsel, Colorado |
| Authorized Official Name and Position | James E Caldwell (OWNER) |
| Authorized Official Contact | 7196482530 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southpark Dental Group Llc 3721 Campfire Rd Hartsel CO 80449-8611 Ph: (719) 648-2530 | Southpark Dental Group Llc 3721 Campfire Rd Hartsel CO 80449 Ph: (719) 648-2530 |
| NPI Number | 1861971772 |
|---|---|
| Provider Enumeration Date | 08/10/2018 |
| Last Update Date | 08/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861971772 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |