Healthcare Provider Details

I. General information

NPI: 1437383205
Provider Name (Legal Business Name): EMBRACEABLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2009
Last Update Date: 05/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 NORTH AVE UNIT 101
GRAND JUNCTION CO
81501-6403
US

IV. Provider business mailing address

2650 NORTH AVE UNIT 101
GRAND JUNCTION CO
81501-6403
US

V. Phone/Fax

Practice location:
  • Phone: 970-255-1222
  • Fax:
Mailing address:
  • Phone: 970-255-1222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. CRAIG BAHR
Title or Position: OWNER
Credential: DMD
Phone: 970-255-1222