MEDICARE: MRS. TERRY DORSEY BALTHAZOR 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
1	1223G0001X	General Practice Dentistry	5456	CO

General Provider Information

NPI Number	:	1457453151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TERRY DORSEY BALTHAZOR DDS

Provider Business Mailing Address
First Line	:	491 FOREST EDGE ROAD
Second Line	:
City	:	WOODLAND PARK
State	:	CO
Zip	:	80863-2499
Country	:	US
Telephone Number	:	719-687-6366
Fax Number	:	719-687-6388

Provider Business Practice Location Address
First Line	:	491 FOREST EDGE ROAD
Second Line	:
City	:	WOODLAND PARK
State	:	CO
Zip	:	80863-2499
Country	:	US
Telephone Number	:	719-687-6366
Fax Number	:	719-687-6388

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1730371485 — DORSEY DENTAL CARE, INC.
Practice Location Address:

491 FOREST EDGE RD
WOODLAND PARK, CO
80863-2499

Practice Phone: 719-687-6366
Practice Fax:

1083071047 — JMJ III
Practice Location Address:

491 FOREST EDGE RD
WOODLAND PARK, CO
80863-2499

Practice Phone: 719-687-6366
Practice Fax: 719-687-6388

1265441265 — DR. JAMES FURTICK JR. PH.D
Practice Location Address:

108 STAGE COACH LANE , VILLAGE PARK
ORANGEBURG, SC
29118-2499

Practice Phone: 803-516-0200
Practice Fax: 803-516-8288

1447367677 — ADVANCE MEDICAL SERVICES
Practice Location Address:

628 E CENTRE PARK BLVD
DESOTO, TX
75115-2499

Practice Phone: 972-458-8393
Practice Fax: 972-458-8304

1518023076 — SECOND CHANCE COUNSELING SERVICES, LLC
Practice Location Address:

108 STAGE COACH LANE , VILLAGE PARK
ORANGEBURG, SC
29118-2499

Practice Phone: 803-516-0200
Practice Fax: 803-516-8288

1841665684 — STACEY BAGANZ BCHN, MS
Practice Location Address:

2499 LEDGER WAY
PARK CITY, UT
84060-1220

Practice Phone: 858-248-5343
Practice Fax:

Directions to “ MRS. TERRY DORSEY BALTHAZOR DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.