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General NPI Number Information
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NPI Number | 1932478336
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Entity Type | Organization
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Legal Business Name | TOOTH FAIRYS, P.C.
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Dates
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Enumeration Date | 12/14/2011
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Last Update Date | 10/11/2021
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Provider Practice Location Address
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Address Line | 2000 VERMONT DR STE 210
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City | FORT COLLINS
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State | CO
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Zip | 80525-2900
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Country | US
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Telephone | 970-227-7202
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 VERMONT DR STE 210
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City | FORT COLLINS
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State | CO
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Zip | 80525-2900
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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 | DENTAL HYGIENIST/OWNER
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Name | MRS. JULIE JO ELLIOTT
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Credential | RDH
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Telephone | 970-227-7202
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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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