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General NPI Number Information
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NPI Number | 1114156379
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Entity Type | Organization
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Legal Business Name | APEX DENTAL, PC
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Dates
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Enumeration Date | 07/09/2009
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Last Update Date | 07/09/2009
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Provider Practice Location Address
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Address Line | 2077 N FRONTAGE RD W STE 101
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City | VAIL
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State | CO
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Zip | 81657-4960
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Country | US
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Telephone | 970-476-4898
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Fax |
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Provider Business Mailing Address
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Address Line | 2077 N FRONTAGE RD W STE 101
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City | VAIL
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State | CO
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Zip | 81657-4960
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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 | PRESIDENT
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Name | MICHAEL HARMS
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Credential | DDS
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Telephone | 970-476-4898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 9142
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License Number State | CO
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