Provider Demographics
NPI:1679039069
Name:OPEN AND AFFORDABLE DENTAL LOVELAND PLLC
Entity Type:Organization
Organization Name:OPEN AND AFFORDABLE DENTAL LOVELAND PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:STOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-644-5058
Mailing Address - Street 1:935 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-4876
Mailing Address - Country:US
Mailing Address - Phone:303-644-5058
Mailing Address - Fax:
Practice Address - Street 1:935 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-4876
Practice Address - Country:US
Practice Address - Phone:303-644-5058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty