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Organization
NORTHERN COLORADO PERIODONTICS
Active
Organization
NORTHERN COLORADO PERIODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY OLSON (PRACTICE MANAGER)
(970) 351-6166
Entity
Organization
Contact information
Practice address
3400 W 16TH ST, SUITE 5X, GREELEY, CO 80634-6862
(970) 351-6166
(970) 673-8732
Mailing address
4033 BOARDWALK DR, SUITE 100, FORT COLLINS, CO 80525-5934
(970) 207-4061
(970) 207-0051
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
8350
CO
Other
Enumeration date
09/15/2014
Last updated
09/15/2014
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