| College Ave Modern Dental | |
|
3617 S College Ave Unit B Fort Collins CO 80525-3009 | |
| (970) 233-8933 | |
| (888) 790-7062 |
| Full Name | College Ave Modern Dental |
|---|---|
| Speciality | Dentist |
| Location | 3617 S College Ave Unit B, Fort Collins, Colorado |
| Authorized Official Name and Position | Scott Frederick (OWNER/DENTIST) |
| Authorized Official Contact | 9702338933 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| College Ave Modern Dental 3617 S College Ave Unit B Fort Collins CO 80525-3009 Ph: (970) 233-8933 | College Ave Modern Dental 3617 S College Ave Unit B Fort Collins CO 80525-3009 Ph: (970) 233-8933 |
| NPI Number | 1205358017 |
|---|---|
| Provider Enumeration Date | 07/13/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205358017 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 10115 (Colorado) | Primary |
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