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General NPI Number Information
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NPI Number | 1558575167
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Entity Type | Organization
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Legal Business Name | PLATTE RIVER FAMILY DENTAL P C
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 965 PLATTE RIVER BLVD UNIT E
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City | BRIGHTON
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State | CO
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Zip | 80601-4353
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Country | US
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Telephone | 303-659-8200
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Fax | 720-685-9113
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Provider Business Mailing Address
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Address Line | 965 PLATTE RIVER BLVD UNIT E
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City | BRIGHTON
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State | CO
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Zip | 80601-4353
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Country | US
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Telephone | 303-659-8200
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Fax | 720-685-9113
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Authorized Official
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Title or Position | CEO PRESIDENT
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Name | DR. PASCO W SCARPELLA
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Credential | D D S
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Telephone | 303-659-8200
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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 | 106313
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License Number State | CO
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