Aaa Family Dental Center III PC
Organization Active NPI Dentist · Georgetown, CO
NPI 1376733501 · NPPES record last updated Aug 7, 2008
Key facts
- NPI
- 1376733501
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 105584 (CO)
- Legal business name
- AAA FAMILY DENTAL CENTER III PC
- Practice address
- 801 6TH St
Georgetown, CO 80444-1022 - Phone
- (303) 569-3141
- Fax
- (303) 569-3041
- NPI assigned
- Jul 25, 2007
- Organization subpart
- No
Authorized official
- Name
- Thomas Losacco, D.D.S.
- Title
- President
- Phone
- (303) 569-3141
Practitioners 1
-
Thomas Losacco, D.D.S.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 105584 | CO | Yes |
| General Practice Dentistry |
1223G0001X | 105584 | CO |
Addresses
Primary practice location
801 6TH St
Georgetown, CO 80444-1022
Mailing address
PO Box 1022
Georgetown, CO 80444-1022
Phone (303) 569-3141
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04011847 | Medicaid | CO |
Other providers in Georgetown, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.