A Country Dentist, PLLC
Clinic/Center, Dental in Fort Morgan, CO. Organization (NPI-2).
NPI number1669977427
StatusActive
Last updated in NPPESMar 26, 2018
Details
- NPI
- 1669977427
- Entity type
- Organization (NPI-2)
- Legal business name
- A Country Dentist, PLLC
- Organization subpart
- No
- Enumeration date
- Mar 26, 2018
- Last updated
- Mar 26, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | 106313 | CO | Yes |
Practice location
107 W 9th AveFort Morgan, CO 80701-2011
Phone 970-867-2502 · Fax 970-867-3795
Mailing address
107 W 9th AveFort Morgan, CO 80701-2011
Phone 970-867-2502 · Fax 970-867-3795
Authorized official
Pasco W Scarpella
Manager
3033358160
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