MEDICARE: ABSOLUTE DENTAL, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1710282793
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABSOLUTE DENTAL, P.C.

Provider Business Mailing Address
First Line	:	1015 S TAFT HILL RD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-4240
Country	:	US
Telephone Number	:	970-482-6034
Fax Number	:	970-980-2143

Provider Business Practice Location Address
First Line	:	1015 S TAFT HILL RD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80521-4240
Country	:	US
Telephone Number	:	970-482-6034
Fax Number	:	970-980-2143

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DAVID B ROBINSON
Credential	:	DDS
Telephone Number	:	970-482-6034

Provider Enumeration Date	:	01/21/2011
Last Update Date	:	02/23/2011

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