Modern Dental Professionals Co PC

NPI #1437530821 in Longmont, Colorado

Provider Information

NPI Number: 1437530821
Entity Type: Organization
Organization Name: Modern Dental Professionals Co PC
Subpart: Yes (part of a larger organization)
Parent Organization: MODERN DENTAL PROFESSIONALS CO PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 11, 2015
Last Updated: Jun 11, 2015

Practice Location

Address: 15 KEN PRATT BLVD STE 280
City: Longmont
State: Colorado
ZIP Code: 80501-8656
Phone: (303) 678-1155

Authorized Official

Name: DR. CRAIG A MELLOR, DDS
Title: PC OWNER
Phone: (303) 209-2250

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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