| NPI | 1013224062 |
|---|---|
| Doing Business As | FORT COLLINS MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CHARLES F RODGERS Owner 970-482-4455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2010-09-10 |