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General NPI Number Information
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NPI Number | 1477123479
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Entity Type | Individual
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Provider Name | ALEXA CRETE DDS
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Gender | Female
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 03/14/2022
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Provider Practice Location Address
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Address Line | 1343 E PROSPECT RD
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City | FORT COLLINS
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State | CO
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Zip | 80525-1115
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Country | US
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Telephone | 970-484-3959
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 N 5TH ST
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City | JOHNSTOWN
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State | CO
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Zip | 80534-5617
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Country | US
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Telephone | 970-775-4348
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DEN.00204812
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License Number State | CO
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