Organization
FORT LUPTON DENTAL GROUP P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRENE MARGARET HOLLOMA D.D.S. (OWNER DENTIST)
(303) 857-4377
Entity
Organization
Contact information
Practice address
229 DENVER AVE, FORT LUPTON, CO 80621-1819
(303) 857-4377
Mailing address
229 DENVER AVE, FORT LUPTON, CO 80621-1819
(303) 857-4377
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
HD104267
CO
Other
Enumeration date
05/22/2008
Last updated
05/22/2008
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