| Colorado West Endodontics Llc | |
|
1190 Bookcliff Ave #204 Grand Junction CO 81501 | |
| (970) 242-9088 | |
| (970) 257-0255 |
| Full Name | Colorado West Endodontics Llc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 1190 Bookcliff Ave, Grand Junction, Colorado |
| Authorized Official Name and Position | Paul Wayne Northup (CO OWNER) |
| Authorized Official Contact | 9702429088 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Colorado West Endodontics Llc 1190 Bookcliff Ave #204 Grand Junction CO 81501 Ph: (970) 242-9088 | Colorado West Endodontics Llc 1190 Bookcliff Ave #204 Grand Junction CO 81501 Ph: (970) 242-9088 |
| NPI Number | 1326149915 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326149915 | NPI | - | NPPES |
| 822910 | Other | UNITED CONCORDIA INS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 7175 (Colorado) | Secondary |
| 1223E0200X | Dentist - Endodontics | 7116 (Colorado) | Primary |
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