Colorado Dhca, Longmont, Pllc

NPI #1700921368 in Longmont, Colorado

Provider Information

NPI Number: 1700921368
Entity Type: Organization
Organization Name: Colorado Dhca, Longmont, Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 21, 2007
Last Updated: Jul 9, 2008

Practice Location

Address: 1260 S HOVER ST UNIT H
City: Longmont
State: Colorado
ZIP Code: 80501-7911
Phone: (303) 678-1125

Authorized Official

Name: LYNN WILSON
Title: MANAGER
Phone: (303) 678-1125

Specialties & Taxonomy Codes

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

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