Individual
DR. JUSTIN KIMBALL LIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, CDT
Contact information
Practice address
2001 S SHIELDS ST STE B1, FORT COLLINS, CO 80526-1829
(970) 224-4358
(970) 224-4388
Mailing address
2001 S SHIELDS ST STE B1, FORT COLLINS, CO 80526-1829
(970) 224-4358
(970) 224-4388
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
10142
CO
Other
Enumeration date
07/23/2010
Last updated
07/23/2010
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