Organization
NORTHERN COLORADO ENDODONTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY DAVID LEVALLEY DDS MS (PRESIDENT)
(970) 229-1404
Entity
Organization
Contact information
Practice address
730 WHALERS WAY, SUITE 300, FT COLLINS, CO 80525
(970) 229-1404
(970) 229-1422
Mailing address
3744 S TIMBERLINE RD, SUITE 101, FORT COLLINS, CO 80525-4333
(970) 229-1404
(970) 229-1422
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
7256
CO
1223E0200X
Endodontics
7382
CO
Other
Enumeration date
07/28/2006
Last updated
08/08/2007
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