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Organization

MOD LLC

Active
Other names
KidsFirst Dental
Organization subpart
No

Provider details

NPI number
Authorized official
LUKE MILMONT (PEDIATRIC DENTIST)
(307) 772-1793
Entity
Organization

Contact information

Practice address
2121 MIDPOINT DR, SUITE 102, FORT COLLINS, CO 80525-4339
(970) 484-5437
(970) 484-5436
Mailing address
2121 MIDPOINT DR, SUITE 102, FORT COLLINS, CO 80525-4339
(970) 484-5437
(970) 484-5436

Taxonomy

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

Other

Enumeration date
11/11/2013
Last updated
12/01/2016
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