Organization
STRASBURG DENTAL GROUP
Active
Other names
Limon Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
TABATHA C NORTHUP (OFFICE MANAGER)
(719) 775-0300
Entity
Organization
Contact information
Practice address
820 1ST ST, LIMON, CO 80828
(719) 775-0300
(719) 775-0302
Mailing address
PO BOX 160, LIMON, CO 80828-0160
(719) 775-0300
(719) 775-0302
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8950
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90079329
—
CO
Enumeration date
08/04/2005
Last updated
08/22/2020
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