MEDICARE: HARMONY DENTAL PARTNERS LLP

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
2	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1285235846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARMONY DENTAL PARTNERS LLP

Provider Business Mailing Address
First Line	:	2132 E HARMONY RD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-9504
Country	:	US
Telephone Number	:	970-287-3701
Fax Number	:	970-287-3702

Provider Business Practice Location Address
First Line	:	2132 E HARMONY RD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-9504
Country	:	US
Telephone Number	:	970-287-3701
Fax Number	:	970-287-3702

Authorized Official
Title or Position	:	PARTNER / OWNER
Name	:	DR. JOLLY JOHNSON
Credential	:	DDS
Telephone Number	:	970-372-7788

Provider Enumeration Date	:	11/02/2020
Last Update Date	:	11/02/2020

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