Provider Demographics
NPI:1861095341
Name:CARA JONES DDS LLC
Entity type:Organization
Organization Name:CARA JONES DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKKEEPPER
Authorized Official - Prefix:
Authorized Official - First Name:MAGALI
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-673-8411
Mailing Address - Street 1:2918 W 10TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-5457
Mailing Address - Country:US
Mailing Address - Phone:970-673-8411
Mailing Address - Fax:
Practice Address - Street 1:2918 W 10TH ST STE 1
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-5457
Practice Address - Country:US
Practice Address - Phone:970-673-8411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARA JONES DDS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000173559Medicaid