| Northeast Family Dental Clinic | |
|
115 South Colorado Ave Hastun CO 80731 | |
| (970) 774-7999 | |
| (970) 774-7997 |
| Full Name | Northeast Family Dental Clinic |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 115 South Colorado Ave, Hastun, Colorado |
| Authorized Official Name and Position | Aaron C Wood (CEO) |
| Authorized Official Contact | 9707746123 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Family Dental Clinic Po Box 248 Haxtun CO 80731 Ph: (970) 774-7999 | Northeast Family Dental Clinic 115 South Colorado Ave Hastun CO 80731 Ph: (970) 774-7999 |
| NPI Number | 1154486272 |
|---|---|
| Provider Enumeration Date | 12/27/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154486272 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | CO8895 (Colorado) | Primary |