Organization
PREMIER RURAL FAMILY MEDICAL & DENTAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM J ROBERS (ATTORNEY)
(719) 634-5700
Entity
Organization
Contact information
Practice address
1101 TELLER COUNTY ROAD 1, CRIPPLE CREEK, CO 80813
(419) 508-7686
Mailing address
24 S WEBER ST STE 400, COLORADO SPRINGS, CO 80903-1928
(719) 634-5700
(719) 633-8477
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/19/2018
Last updated
04/19/2018
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