| Northern Colorado Endodontics Pc | |
|
730 Whalers Way Suite 300 Ft Collins CO 80525 | |
| (970) 229-1404 | |
| (970) 229-1422 |
| Full Name | Northern Colorado Endodontics Pc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 730 Whalers Way, Ft Collins, Colorado |
| Authorized Official Name and Position | Bradley David Levalley (PRESIDENT) |
| Authorized Official Contact | 9702291404 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Colorado Endodontics Pc 3744 S Timberline Rd Suite 101 Fort Collins CO 80525-4333 Ph: (970) 229-1404 | Northern Colorado Endodontics Pc 730 Whalers Way Suite 300 Ft Collins CO 80525 Ph: (970) 229-1404 |
| NPI Number | 1184638736 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 08/08/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184638736 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 7382 (Colorado) | Secondary |
| 1223E0200X | Dentist - Endodontics | 7256 (Colorado) | Primary |