Provider Demographics
NPI:1659002160
Name:OPEN AND AFFORDABLE DENTAL FORT COLLINS SOUTH PLLC
Entity Type:Organization
Organization Name:OPEN AND AFFORDABLE DENTAL FORT COLLINS SOUTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIPER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:620-755-2709
Mailing Address - Street 1:3838 S TIMBERLINE RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3415
Mailing Address - Country:US
Mailing Address - Phone:970-632-9006
Mailing Address - Fax:
Practice Address - Street 1:3838 S TIMBERLINE RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3415
Practice Address - Country:US
Practice Address - Phone:970-632-9006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty