# A COUNTRY DENTIST, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669977427
- **Authorized official:** DR. PASCO W SCARPELLA DDS (MANAGER)
- **Authorized official phone:** (303) 335-8160

## Contact information

- **Practice address:** 107 W 9TH AVE, FORT MORGAN, CO 80701-2011
- **Practice address phone:** (970) 867-2502
- **Practice address fax:** (970) 867-3795
- **Mailing address:** 107 W 9TH AVE, FORT MORGAN, CO 80701-2011
- **Mailing address phone:** (970) 867-2502
- **Mailing address fax:** (970) 867-3795

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 106313 | CO | Yes |

## Other

- **Enumeration date:** 03/26/2018
- **Last updated:** 03/26/2018