Provider Demographics
NPI:1518351691
Name:CRANE & SEAGER ORTHODONTICS
Entity Type:Organization
Organization Name:CRANE & SEAGER ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BREANN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBER-MOEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-226-6443
Mailing Address - Street 1:4144 S TIMBERLINE RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-6029
Mailing Address - Country:US
Mailing Address - Phone:970-226-6443
Mailing Address - Fax:970-266-2741
Practice Address - Street 1:4144 S TIMBERLINE RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-6029
Practice Address - Country:US
Practice Address - Phone:970-226-6443
Practice Address - Fax:970-266-2741
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRANE & SEAGER ORTHODONTIVS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO84461223X0400X
CO99621223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty