Organization
BANNER ANESTHESIOLOGISTS COLORADO LLC
Active
Parent organization
BANNER MEDICAL GROUP COLORADO
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER MEDICAL GROUP COLORADO
Authorized official
DENNIS DAHLEN (SR VP FINANCE)
(602) 747-4000
Entity
Organization
Contact information
Practice address
4700 LADY MOON DR, FORT COLLINS, CO 80528-4426
(970) 350-6399
(970) 229-4501
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/02/2015
Last updated
03/02/2015
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