MEDICARE: AGREEABLE DENTAL CARE LLC

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	6354	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548529217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGREEABLE DENTAL CARE LLC

Provider Business Mailing Address
First Line	:	1700 S CHAMBERS RD
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80017-5023
Country	:	US
Telephone Number	:	303-369-7272
Fax Number	:	303-369-1098

Provider Business Practice Location Address
First Line	:	1700 S CHAMBERS RD
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80017-5023
Country	:	US
Telephone Number	:	303-369-7272
Fax Number	:	303-369-1098

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	MARC G RESNICK
Credential	:	D.D.S.
Telephone Number	:	303-369-7272

Provider Enumeration Date	:	05/15/2012
Last Update Date	:	05/15/2012

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Directions to “AGREEABLE DENTAL CARE LLC ” Practice Location

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