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General NPI Number Information
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NPI Number | 1962803429
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Entity Type | Organization
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Legal Business Name | S. MATT SCHACHT, D.D.S., PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/15/2014
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 130 RAMPART WAY STE 100
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City | DENVER
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State | CO
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Zip | 80230-6443
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Country | US
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Telephone | 303-341-7151
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Fax |
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Provider Business Mailing Address
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Address Line | 4600 S SYRACUSE ST STE 900
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City | DENVER
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State | CO
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Zip | 80237-2701
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Country | US
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Telephone | 305-450-9515
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHEN MATTHEW SCHACHT
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Credential | D.D.S.
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Telephone | 305-450-9515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 202231
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License Number State | CO
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