Individual
KURT PHILIP MACEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8031 CAMPUS DELIVERY, COLORADO STATE UNIVERSITY, FORT COLLINS, CO 80523-8031
(970) 491-1710
Mailing address
1080 SHADOW RIDGE RD, LAPORTE, CO 80535-9724
(970) 416-6487
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9859
CO
Other
Enumeration date
10/01/2009
Last updated
10/01/2009
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