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NPI Code Detail

MEDICARE: DR. KENT J SPILLMAN DDS

MEDICARE:  DR. KENT J SPILLMAN  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0300XPeriodontics104748CO

General Provider Information

NPI Number : 1043387020
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENT J SPILLMAN DDS
Provider Business Mailing Address
First Line : 7502 WEST 80TH AVE
Second Line : SUITE 100
City : ARVADA
State : CO
Zip : 80003-2147
Country : US
Telephone Number : 303-424-7757
Fax Number : 303-403-0268
Provider Business Practice Location Address
First Line : 7502 WEST 80TH AVE
Second Line : SUITE 100
City : ARVADA
State : CO
Zip : 80003-2147
Country : US
Telephone Number : 303-424-7757
Fax Number : 303-403-0268
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2006
Last Update Date : 07/08/2007

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Directions to “ DR. KENT J SPILLMAN DDS” Practice Location

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