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General NPI Number Information
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NPI Number | 1659978138
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Entity Type | Organization
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Legal Business Name | TAFT HILL ORTHODONTICS OF GREELEY PLLC
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Dates
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Enumeration Date | 10/07/2020
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 3400 W 16TH ST # 8E
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City | GREELEY
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State | CO
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Zip | 80634-6862
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Country | US
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Telephone | 970-415-8581
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Fax |
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Provider Business Mailing Address
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Address Line | 3200 VILLAGE VISTA DR UNIT 110
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City | ERIE
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State | CO
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Zip | 80516-2596
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Country | US
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Telephone | 720-900-3119
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | TIMOTHY C HARDY
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Credential | DMD
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Telephone | 970-415-8581
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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 |
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License Number State |
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