Organization
FRONT RANGE DENTAL CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KURT RADTKE (OFFICE MANAGER)
(970) 673-7321
Entity
Organization
Contact information
Practice address
2720 COUNCIL TREE AVE, SUITE 260, FORT COLLINS, CO 80525-6306
(970) 673-7321
(855) 889-6591
Mailing address
2720 COUNCIL TREE AVE, SUITE 260, FORT COLLINS, CO 80525-6306
(970) 673-7321
(855) 889-6591
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
202039
CO
1223G0001X
General Practice Dentistry
Primary
8604
CO
1223G0001X
General Practice Dentistry
9157
CO
1223G0001X
General Practice Dentistry
9442
CO
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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