| Just For Grins Llc | |
|
6436 S Us Highway 85-87 Suite C Fountain CO 80817 | |
| (719) 392-5111 | |
| (719) 392-4143 |
| Full Name | Just For Grins Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6436 S Us Highway 85-87, Fountain, Colorado |
| Authorized Official Name and Position | Tim Montano (BUSINESS MANAGER) |
| Authorized Official Contact | 7193925111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Just For Grins Llc 6436 S Us Highway 85-87 Suite C Fountain CO 80817-1005 Ph: (719) 392-5111 | Just For Grins Llc 6436 S Us Highway 85-87 Suite C Fountain CO 80817 Ph: (719) 392-5111 |
| NPI Number | 1205028941 |
|---|---|
| Provider Enumeration Date | 08/16/2007 |
| Last Update Date | 05/30/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205028941 | NPI | - | NPPES |
| 31100058 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8170 (Colorado) | Primary |
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