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Organization

SHAWN M CUSTER DENTAL PLLC

Active
Other names
Park View Family Dental Ft. Collins
Organization subpart
Yes

Provider details

NPI number
Authorized official
SHAWN MICHAEL CUSTER (OWNER)
(402) 721-8200
Entity
Organization

Contact information

Practice address
3950 JOHN F KENNEDY PKWY UNIT E, FORT COLLINS, CO 80525-3074
(970) 732-4371
Mailing address
3950 JOHN F KENNEDY PKWY UNIT E, FORT COLLINS, CO 80525-3074
(970) 732-4371

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000154967
CO
Enumeration date
01/19/2022
Last updated
01/19/2022
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