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General NPI Number Information
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NPI Number | 1962283564
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Entity Type | Organization
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Legal Business Name | OWENS DENTAL BERTHOUD, P.C.
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Dates
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Enumeration Date | 10/10/2023
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 509 7TH ST
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City | BERTHOUD
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State | CO
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Zip | 80513-5016
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Country | US
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Telephone | 970-444-5464
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Fax |
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Provider Business Mailing Address
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Address Line | 509 7TH ST
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City | BERTHOUD
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State | CO
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Zip | 80513-5016
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Country | US
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Telephone | 970-444-5464
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Fax |
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Authorized Official
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Title or Position | OWNER, DENTIST
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Name | DR. TIMOTHY M OWENS
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Credential | DDS
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Telephone | 970-631-6977
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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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