MEDICARE: MILE HIGH DENTAL PROF 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	8479	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	:	1669757415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILE HIGH DENTAL PROF LLC

Provider Business Mailing Address
First Line	:	881 FEDERAL BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-3212
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	881 FEDERAL BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-3212
Country	:	US
Telephone Number	:	303-359-9814
Fax Number	:

Authorized Official
Title or Position	:	PARTNER/OWNER
Name	:	DR. JAMES PARFITT
Credential	:	D.M.D.
Telephone Number	:	303-359-9814

Provider Enumeration Date	:	10/12/2011
Last Update Date	:	10/12/2011

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Directions to “MILE HIGH DENTAL PROF LLC ” Practice Location

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