Provider Demographics
NPI:1275089617
Name:NCDI OAK, PROFESSION LLP
Entity Type:Organization
Organization Name:NCDI OAK, PROFESSION LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-223-8687
Mailing Address - Street 1:1220 OAK PARK DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-7348
Mailing Address - Country:US
Mailing Address - Phone:970-223-8687
Mailing Address - Fax:970-225-1574
Practice Address - Street 1:1220 OAK PARK DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-7348
Practice Address - Country:US
Practice Address - Phone:970-223-8687
Practice Address - Fax:970-225-1574
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SVC DENTAL GROUP, PROFESSIONAL LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty