Provider Demographics
NPI:1275502924
Name:COATS, BRIAN FREDERICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:FREDERICK
Last Name:COATS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 SUMNER ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-3271
Mailing Address - Country:US
Mailing Address - Phone:303-776-4090
Mailing Address - Fax:
Practice Address - Street 1:1305 SUMNER ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3271
Practice Address - Country:US
Practice Address - Phone:303-776-4090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO69151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice