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General NPI Number Information
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NPI Number | 1598496416
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Entity Type | Organization
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Legal Business Name | BRIMHALL FAMILY DENTISTRY
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Dates
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Enumeration Date | 06/21/2022
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Last Update Date | 08/30/2022
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Provider Practice Location Address
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Address Line | 1033 ROBERTSON ST
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City | FORT COLLINS
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State | CO
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Zip | 80524-3926
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Country | US
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Telephone | 970-482-4242
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Fax | 970-482-0610
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Provider Business Mailing Address
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Address Line | 1033 ROBERTSON ST
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City | FORT COLLINS
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State | CO
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Zip | 80524-3926
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Country | US
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Telephone | 970-482-4242
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Fax | 970-482-0610
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ASHLEY BRIMHALL
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Credential |
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Telephone | 970-278-7917
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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 |
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License Number State |
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