MEDICARE: RESTORAL DENTAL FC LLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1891637922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESTORAL DENTAL FC LLC

Provider Business Mailing Address
First Line	:	201 W PINE ST STE B
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70501-2913
Country	:	US
Telephone Number	:	337-337-4114
Fax Number	:

Provider Business Practice Location Address
First Line	:	3950 JOHN F KENNEDY PKWY UNIT E
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3074
Country	:	US
Telephone Number	:	337-523-4556
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTOPHER SAVOY
Credential	:
Telephone Number	:	337-523-4556

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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