MEDICARE: HOWARD CHRIS YURK D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	653	CO

General Provider Information

NPI Number	:	1164460127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOWARD CHRIS YURK D.D.S.

Provider Business Mailing Address
First Line	:	2290 W 46TH ST
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-1467
Country	:	US
Telephone Number	:	970-203-0096
Fax Number	:

Provider Business Practice Location Address
First Line	:	COLORADO STATE UNIVERSITY - HARTSHORN HEALTH SERVI
Second Line	:	HARTSHORN BUILDING (8031)
City	:	FORT COLLINS
State	:	CO
Zip	:	80523-0001
Country	:	US
Telephone Number	:	970-491-1710
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	07/08/2007

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