Provider Demographics
NPI:1144878521
Name:PARTNERS IN PERIODONTICS PLLC
Entity type:Organization
Organization Name:PARTNERS IN PERIODONTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:COLLETTE
Authorized Official - Last Name:HOLLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-669-7300
Mailing Address - Street 1:1625 FOXTRAIL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9089
Mailing Address - Country:US
Mailing Address - Phone:970-669-7300
Mailing Address - Fax:970-669-7301
Practice Address - Street 1:1625 FOXTRAIL DR STE 100
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9089
Practice Address - Country:US
Practice Address - Phone:970-669-7300
Practice Address - Fax:970-669-7301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty