| Woodmoor Family Dentistry | |
| 
					1777 Lake Woodmoor Dr Monument CO 80132-9074  | |
| (719) 488-3014 | |
| (719) 488-3015 | 
| Full Name | Woodmoor Family Dentistry | 
|---|---|
| Speciality | Clinic/center - Dental | 
| Location | 1777 Lake Woodmoor Dr, Monument, Colorado | 
| Authorized Official Name and Position | Andrew Wilson Dethloff (OWNER/DENTIST) | 
| Authorized Official Contact | 7194883014 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Woodmoor Family Dentistry 1777 Lake Woodmoor Dr Monument CO 80132-9074 Ph: (719) 488-3014  | Woodmoor Family Dentistry 1777 Lake Woodmoor Dr Monument CO 80132-9074 Ph: (719) 488-3014  | 
| NPI Number | 1346833571 | 
|---|---|
| Provider Enumeration Date | 02/18/2021 | 
| Last Update Date | 02/18/2021 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1346833571 | NPI | - | NPPES | 
| 9000181282 | Medicaid | CO | 
| 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  | |
Jeffrey Yelle Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 18925 Base Camp Rd, Monument, CO 80132 Phone: 719-488-2375  | |
Woodmoor Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1777 Lake Woodmoor Dr, Monument, CO 80132 Phone: 719-488-3014  | |
Palmer Ridge Dental And Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1777 Lake Woodmoor Dr, Monument, CO 80132 Phone: 719-488-3014 Fax: 719-488-3015  | |
Co Specialty Dental Services Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1415 Cipriani Loop, Monument, CO 80132 Phone: 719-596-3113  | |
David J Jones Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 18925 Base Camp Rd, Monument, CO 80132 Phone: 719-488-2375 Fax: 719-488-9315  |