Provider Demographics
NPI:1013898469
Name:ADMIRE DENTAL OF FORT COLLINS PLLC
Entity type:Organization
Organization Name:ADMIRE DENTAL OF FORT COLLINS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRANSITIONS AND OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAGGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-269-0628
Mailing Address - Street 1:360 QUEEN ST STE 205
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-1883
Mailing Address - Country:US
Mailing Address - Phone:970-930-3396
Mailing Address - Fax:
Practice Address - Street 1:1513 RIVERSIDE AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4348
Practice Address - Country:US
Practice Address - Phone:970-930-3396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental