Healthcare Provider Details
I. General information
NPI: 1669288510
Provider Name (Legal Business Name): ONTO FERTILITY OF COLORADO PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/05/2024
Last Update Date: 12/05/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12770 LYNNFIELD DR
PARKER CO
80134
US
IV. Provider business mailing address
9615 E COUNTY LINE RD STE B
CENTENNIAL CO
80112-3531
US
V. Phone/Fax
- Phone: 303-999-3877
- Fax:
- Phone: 352-239-8099
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VE0102X |
| Taxonomy | Reproductive Endocrinology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
DALLAINA
RACE
Title or Position: DIRECTOR OF ADMINISTRATION
Credential:
Phone: 352-239-8099