| Shawn M Custer Dental Pllc | |
|
3950 John F Kennedy Pkwy Unit E Fort Collins CO 80525-3074 | |
| (970) 732-4371 | |
| Not Available |
| Full Name | Shawn M Custer Dental Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3950 John F Kennedy Pkwy Unit E, Fort Collins, Colorado |
| Authorized Official Name and Position | Shawn Michael Custer (OWNER) |
| Authorized Official Contact | 4027218200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shawn M Custer Dental Pllc 3950 John F Kennedy Pkwy Unit E Fort Collins CO 80525-3074 Ph: (970) 732-4371 | Shawn M Custer Dental Pllc 3950 John F Kennedy Pkwy Unit E Fort Collins CO 80525-3074 Ph: (970) 732-4371 |
| NPI Number | 1255083473 |
|---|---|
| Provider Enumeration Date | 01/19/2022 |
| Last Update Date | 01/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255083473 | NPI | - | NPPES |
| 9000154967 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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