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General NPI Number Information
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NPI Number | 1043601826
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Entity Type | Organization
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Legal Business Name | JILL KOLLAR DMD PROFESSIONAL LLC
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Dates
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Enumeration Date | 02/14/2015
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Last Update Date | 02/14/2015
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Provider Practice Location Address
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Address Line | 1580 MAIN ST SUITE B
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City | WINDSOR
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State | CO
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Zip | 80550-7918
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Country | US
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Telephone | 970-988-1817
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Fax |
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Provider Business Mailing Address
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Address Line | 1580 MAIN ST SUITE B
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City | WINDSOR
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State | CO
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Zip | 80550-7918
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JILL CHRISTINA KOLLAR
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Credential | DMD
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Telephone | 970-988-1817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN00201892
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License Number State | CO
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