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Northern Colorado Endodontics

Dentist, Endodontics in Longmont, CO. Organization (NPI-2).

NPI number1407205461
StatusActive
Last updated in NPPESJun 9, 2016

Details

NPI
1407205461
Entity type
Organization (NPI-2)
Legal business name
Northern Colorado Endodontics
Organization subpart
Yes
Enumeration date
Jun 9, 2016
Last updated
Jun 9, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223E0200X Dentist, Endodontics7382COYes

Practice location

630 15th Ave
Suite 301
Longmont, CO 80501-2700

Phone 720-494-9363 · Fax 720-494-9364

Mailing address

630 15th Ave
Suite 301
Longmont, CO 80501-2700

Phone 720-494-9363 · Fax 720-494-9364

Authorized official

Bradley Levalley
President
9702291404

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