Organization
SIGNAL TREE FAMILY DENTAL PLLC
Active
Other names
Signal Tree Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BROCK BOOTON DDS (OWNER)
(970) 449-0306
Entity
Organization
Contact information
Practice address
4650 SIGNAL TREE DR # A1800, TIMNATH, CO 80547-4908
(970) 449-0306
Mailing address
4650 SIGNAL TREE DR # A1800, TIMNATH, CO 80547-4908
(970) 449-0306
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699194316
—
CO
Enumeration date
03/21/2024
Last updated
03/21/2024
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