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Organization

FORT MORGAN ORTHODONTIC CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GARY JOSEPH KLOBERDANZ D.D.S. (PRESIDENT)
(970) 542-2500
Entity
Organization

Contact information

Practice address
531 W PLATTE AVE, FORT MORGAN, CO 80701-2654
(970) 542-2500
Mailing address
531 W PLATTE AVE, FORT MORGAN, CO 80701-2654
(970) 542-2500

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
00594
CO

Other

Enumeration date
01/29/2014
Last updated
01/29/2014
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