Organization
SUNRISE COMMUNITY HEALTH
Active
Parent organization
SUNRISE COMMUNITY HEALTH
Other names
Monfort Children's Dental Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUNRISE COMMUNITY HEALTH
Authorized official
CATHY WOLFF (CFO)
(970) 346-2546
Entity
Organization
Contact information
Practice address
100 N 11TH AVE, GREELEY, CO 80631-2011
(970) 313-0353
(970) 351-7075
Mailing address
2930 11TH AVE, EVANS, CO 80620-1011
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
CO
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740791011
—
CO
Enumeration date
10/13/2017
Last updated
05/29/2023
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