Radiant Dental Health | |
313 W Drake Rd Fort Collins CO 80526-2846 | |
(970) 422-1122 | |
(970) 425-1243 |
Full Name | Radiant Dental Health |
---|---|
Speciality | Clinic/center - Dental |
Location | 313 W Drake Rd, Fort Collins, Colorado |
Authorized Official Name and Position | Nathaniel Boone Caldon (OWNER/ DENTIST) |
Authorized Official Contact | 9704221122 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Radiant Dental Health 313 W Drake Rd Fort Collins CO 80526-2846 Ph: (970) 422-1122 | Radiant Dental Health 313 W Drake Rd Fort Collins CO 80526-2846 Ph: (970) 422-1122 |
NPI Number | 1063041374 |
---|---|
Provider Enumeration Date | 04/07/2020 |
Last Update Date | 04/07/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063041374 | NPI | - | NPPES |
1598950669 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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