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General NPI Number Information
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NPI Number | 1144878521
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Entity Type | Organization
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Legal Business Name | PARTNERS IN PERIODONTICS PLLC
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Dates
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Enumeration Date | 08/29/2019
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Last Update Date | 08/29/2019
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Provider Practice Location Address
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Address Line | 1625 FOXTRAIL DR STE 100
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City | LOVELAND
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State | CO
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Zip | 80538-9089
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Country | US
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Telephone | 970-669-7300
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Fax | 970-669-7301
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Provider Business Mailing Address
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Address Line | 1625 FOXTRAIL DR STE 100
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City | LOVELAND
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State | CO
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Zip | 80538-9089
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Country | US
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Telephone | 970-669-7300
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Fax | 970-669-7301
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | LISA COLLETTE HOLLING
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Credential |
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Telephone | 970-669-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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