Organization
FORT MORGAN FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL COLLINS (MEMBER)
(815) 252-0565
Entity
Organization
Contact information
Practice address
1101 W PLATTE AVE, FORT MORGAN, CO 80701
(970) 427-5300
Mailing address
1101 W PLATTE AVE, FORT MORGAN, CO 80701
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
00202511
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26730073
—
CO
Enumeration date
09/23/2016
Last updated
09/23/2016
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