CROSSROADS DENTAL NPI 1407167836

NPI Information

NPI: 1407167836
Provider Name: CROSSROADS DENTAL
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

CLIA Number: 06D2206309

Address:
1520 S HOVER ST STE E-F
LONGMONT, CO
ZIP 80501
Phone: (303) 776-1480
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CROSSROADS DENTAL is a dental clinic center in Longmont, CO. CROSSROADS DENTAL NPI is 1407167836. The provider is registered as an organization entity type.

The provider's business location address is:

1520 S HOVER ST STE E-F
LONGMONT, CO
ZIP 80501-959
Phone: (303) 776-1480

The provider's authorized official is Amy Farmer .
The authorized official title is Dentist and has the following contact phone number (303) 776-1480.

The CLIA number assigned to this NPI record is 06D2206309 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/30/2010 and was last updated on 6/30/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	7850	COLORADO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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