MEDICARE: FLOSSIRAPTER

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
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1114755246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLOSSIRAPTER

Provider Business Mailing Address
First Line	:	7201 E 8TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-4846
Country	:	US
Telephone Number	:	303-333-5148
Fax Number	:	303-388-4650

Provider Business Practice Location Address
First Line	:	7201 E 8TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-4846
Country	:	US
Telephone Number	:	303-333-5148
Fax Number	:	303-388-4650

Authorized Official
Title or Position	:	DENTIST
Name	:	MICHAEL HOAGBURG
Credential	:
Telephone Number	:	260-417-9243

Provider Enumeration Date	:	07/22/2024
Last Update Date	:	08/29/2024

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Directions to “FLOSSIRAPTER ” Practice Location

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