| Limon Dental Group | |
|
820 1st St Limon CO 80828 | |
| (719) 775-0300 | |
| (719) 775-0302 |
| Full Name | Limon Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 820 1st St, Limon, Colorado |
| Authorized Official Name and Position | Tabatha C Northup (OFFICE MANAGER) |
| Authorized Official Contact | 7197750300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Limon Dental Group Po Box 160 Limon CO 80828-0160 Ph: (719) 775-0300 | Limon Dental Group 820 1st St Limon CO 80828 Ph: (719) 775-0300 |
| NPI Number | 1043211667 |
|---|---|
| Provider Enumeration Date | 08/04/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043211667 | NPI | - | NPPES |
| 90079329 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8950 (Colorado) | Primary |
Branon D Johnson Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 170 E. Avenue, Limon, CO 80828 Phone: 719-775-8758 |