Organization
BENDER MEDICAL GROUP, INC
Active
Other names
Miramont Dental Hygiene
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE M DESAIRE (CHIEF BUSINESS DEVELOPMENT OFFICER)
(970) 225-5107
Entity
Organization
Contact information
Practice address
313 W DRAKE RD, FORT COLLINS, CO 80526
(970) 482-8881
(970) 482-9646
Mailing address
4674 SNOW MESA DR, SUITE 140, FORT COLLINS, CO 80528-8615
(970) 482-0213
(970) 482-9646
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH002023867
CO
Other
Enumeration date
10/17/2016
Last updated
12/15/2016
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