| White Diamond Dental | |
|
15854 Jackson Creek Pkwy # 140a Monument CO 80132-8662 | |
| (719) 344-2191 | |
| (719) 247-2295 |
| Full Name | White Diamond Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 15854 Jackson Creek Pkwy # 140a, Monument, Colorado |
| Authorized Official Name and Position | Scott Wayne Hirsbrunner (DENTIST/OWNER) |
| Authorized Official Contact | 7193442191 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| White Diamond Dental 15854 Jackson Creek Pkwy # 140a Monument CO 80132-8662 Ph: (719) 344-2191 | White Diamond Dental 15854 Jackson Creek Pkwy # 140a Monument CO 80132-8662 Ph: (719) 344-2191 |
| NPI Number | 1891663357 |
|---|---|
| Provider Enumeration Date | 10/27/2025 |
| Last Update Date | 10/27/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891663357 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Jackson Creek Dental Care, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 15854 Jackson Creek Pkwy, Suite 140, Monument, CO 80132 Phone: 719-302-2200 Fax: 216-584-1360 | |
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