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NPI Code Detail

MEDICARE: CASTLE ROCK RESTORATIVE

MEDICARE: CASTLE ROCK RESTORATIVE
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
11223P0700XProsthodontics

General Provider Information

NPI Number : 1588382394
Entity Type Code : Organization
Provider Name (Legal Business Name) : CASTLE ROCK RESTORATIVE
Provider Business Mailing Address
First Line : 2700 E BRIDGE ST STE 101
Second Line :
City : BRIGHTON
State : CO
Zip : 80601-2561
Country : US
Telephone Number : 303-659-1825
Fax Number : 720-821-0379
Provider Business Practice Location Address
First Line : 1176 ALOHA ST STE 200A
Second Line :
City : CASTLE ROCK
State : CO
Zip : 80108-2836
Country : US
Telephone Number : 720-703-4609
Fax Number :
Authorized Official
Title or Position : OFFICE MANAGER
Name : SONIA MENINDEZ
Credential :
Telephone Number : 303-659-1825
Provider Enumeration Date : 08/17/2022
Last Update Date : 09/14/2022

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Directions to “CASTLE ROCK RESTORATIVE ” Practice Location

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