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General NPI Number Information
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NPI Number | 1386660520
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Entity Type | Organization
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Legal Business Name | AAA FAMILY DENTAL CENTER I
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 710 EPPINGER BLVD
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City | THORNTON
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State | CO
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Zip | 80229
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Country | US
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Telephone | 303-289-3358
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Fax | 303-765-0167
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Provider Business Mailing Address
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Address Line | 710 EPPINGER BLVD
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City | THORNTON
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State | CO
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Zip | 80229
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Country | US
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Telephone | 303-289-3358
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Fax | 303-765-0167
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | MR. GREGORY DEAN SCHLAGEL
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Credential | DDS
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Telephone | 303-289-3358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | HD104342
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License Number State | CO
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