| Mountain Ridge Dentistry | |
|
310 Mountain Ave Berthoud CO 80513-5004 | |
| (970) 528-0900 | |
| Not Available |
| Full Name | Mountain Ridge Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 310 Mountain Ave, Berthoud, Colorado |
| Authorized Official Name and Position | Austin Deporter (DENTIST, OWNER) |
| Authorized Official Contact | 9705280900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Ridge Dentistry 310 Mountain Ave Po Box 1694 Po Box 1694 Berthoud CO 80513 Ph: (970) 528-0900 | Mountain Ridge Dentistry 310 Mountain Ave Berthoud CO 80513-5004 Ph: (970) 528-0900 |
| NPI Number | 1720759228 |
|---|---|
| Provider Enumeration Date | 09/23/2021 |
| Last Update Date | 09/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720759228 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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