Northeast Family Dental Clinic | |
115 South Colorado Ave Hastun CO 80731 | |
(970) 774-7999 | |
(970) 774-7997 |
Full Name | Northeast Family Dental Clinic |
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Speciality | Clinic/center - Dental |
Location | 115 South Colorado Ave, Hastun, Colorado |
Authorized Official Name and Position | Aaron C Wood (CEO) |
Authorized Official Contact | 9707746123 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Northeast Family Dental Clinic Po Box 248 Haxtun CO 80731 Ph: (970) 774-7999 | Northeast Family Dental Clinic 115 South Colorado Ave Hastun CO 80731 Ph: (970) 774-7999 |
NPI Number | 1154486272 |
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Provider Enumeration Date | 12/27/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1154486272 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | CO8895 (Colorado) | Primary |