MEDICARE: MEADOW HILLS DENTAL

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	:	1730560129
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEADOW HILLS DENTAL

Provider Business Mailing Address
First Line	:	5001 S PARKER RD
Second Line	:	#106
City	:	AURORA
State	:	CO
Zip	:	80015-1182
Country	:	US
Telephone Number	:	303-694-0028
Fax Number	:

Provider Business Practice Location Address
First Line	:	5001 S PARKER RD
Second Line	:	#106
City	:	AURORA
State	:	CO
Zip	:	80015-1182
Country	:	US
Telephone Number	:	303-694-0028
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARK BRAASCH
Credential	:	D.D.S
Telephone Number	:	303-694-0028

Provider Enumeration Date	:	06/11/2015
Last Update Date	:	06/11/2015

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Directions to “MEADOW HILLS DENTAL ” Practice Location

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