Provider Demographics
NPI:1477114676
Name:ENGER, ANNA (DMD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:ENGER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2114 W VINE DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-1507
Mailing Address - Country:US
Mailing Address - Phone:256-239-4077
Mailing Address - Fax:
Practice Address - Street 1:2203 S COLLEGE AVE STE 100
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-1430
Practice Address - Country:US
Practice Address - Phone:970-482-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN002040071223G0001X
TN117521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice