# LONGMONT BRACES

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

## Provider details

- **NPI number:** 1790013936
- **Authorized official:** DR. STEPHANIE ROSS DDS (ORTHODONTIST/OWNER)
- **Authorized official phone:** (303) 994-4401

## Contact information

- **Practice address:** 1520 S HOVER RD STE C, LONGMONT, CO 80501-7960
- **Practice address phone:** (303) 772-0510
- **Mailing address:** 1981 EMERALD DR, LONGMONT, CO 80504-7778

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 9671 | CO | Yes |

## Other

- **Enumeration date:** 11/30/2009
- **Last updated:** 11/30/2009