Organization
LONGMONT BRACES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE ROSS DDS (ORTHODONTIST/OWNER)
(303) 994-4401
Entity
Organization
Contact information
Practice address
1520 S HOVER RD STE C, LONGMONT, CO 80501-7960
(303) 772-0510
Mailing address
1981 EMERALD DR, LONGMONT, CO 80504-7778
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
9671
CO
Other
Enumeration date
11/30/2009
Last updated
11/30/2009
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