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1295 Main St #4 Windsor CO 80550-5966 | |
(970) 674-0717 | |
Not Available |
Full Name | |
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Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 1295 Main St, Windsor, Colorado |
Authorized Official Name and Position | Jill K Mioduski (OWNER/ORTHODONTIST) |
Authorized Official Contact | 9706740717 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1295 Main St #4 Windsor CO 80550-5966 Ph: (970) 674-0717 | 1295 Main St #4 Windsor CO 80550-5966 Ph: (970) 674-0717 |
NPI Number | 1598040578 |
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Provider Enumeration Date | 10/20/2011 |
Last Update Date | 10/20/2011 |
Identifier | Type | State | Issuer |
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1598040578 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 10178 (Colorado) | Primary |
Noco Ortho Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1299 Main St Unit C, Windsor, CO 80550 Phone: 970-674-0717 | |