MEDICARE: DR. JENNIFER K HARGLEROAD D.D.S., M.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	1223P0221X	Pediatric Dentistry	8365	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992894562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER K HARGLEROAD D.D.S., M.S.

Provider Business Mailing Address
First Line	:	2105 BIGHORN RD STE 202
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3575
Country	:	US
Telephone Number	:	970-493-2254
Fax Number	:	970-493-0940

Provider Business Practice Location Address
First Line	:	2105 BIGHORN RD STE 202
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3575
Country	:	US
Telephone Number	:	970-493-2254
Fax Number	:	970-493-0940

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

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	03/11/2020

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