Provider Demographics
NPI:1790395028
Name:JEFF MARLOR DMD PC
Entity Type:Organization
Organization Name:JEFF MARLOR DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:MARLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:719-338-3031
Mailing Address - Street 1:1907 BOISE AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-4291
Mailing Address - Country:US
Mailing Address - Phone:970-667-5424
Mailing Address - Fax:
Practice Address - Street 1:1907 BOISE AVE STE 4
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-4291
Practice Address - Country:US
Practice Address - Phone:970-667-5424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-02
Last Update Date:2020-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental