Organization
JENNIFER K HARGLEROAD DDS MS PROFESSIONAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER KAY HARGLEROAD DDS MS (OWNER MEMBER)
(970) 493-2254
Entity
Organization
Contact information
Practice address
2105 BIGHORN RD, SUITE 202, FORT COLLINS, CO 80525-3555
(970) 232-9097
Mailing address
2105 BIGHORN RD, SUITE 202, FORT COLLINS, CO 80525-3555
(970) 232-9097
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
8365
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54182336
—
CO
05
—
78907811
—
CO
Enumeration date
06/15/2015
Last updated
06/15/2015
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