South Greeley, Prof. LLC

NPI #1053811463 in Greeley, Colorado

Provider Information

NPI Number: 1053811463
Entity Type: Organization
Organization Name: South Greeley, Prof. LLC
Primary Specialty: Dentist
Enumeration Date: Feb 13, 2018
Last Updated: Feb 13, 2018

Practice Location

Address: 2716 11TH AVE
City: Greeley
State: Colorado
ZIP Code: 80631-8443
Phone: (970) 673-4310

Authorized Official

Name: JARUM BOYER, DMD
Title: DENTIST/OWNER
Phone: (970) 673-4310

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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