Organization
A COUNTRY DENTIST, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PASCO W SCARPELLA DDS (MANAGER)
(303) 335-8160
Entity
Organization
Contact information
Practice address
107 W 9TH AVE, FORT MORGAN, CO 80701-2011
(970) 867-2502
(970) 867-3795
Mailing address
107 W 9TH AVE, FORT MORGAN, CO 80701-2011
(970) 867-2502
(970) 867-3795
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
106313
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32871716
—
CO
Enumeration date
03/26/2018
Last updated
03/26/2018
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