Organization Name: | FALCON HILLS DENTAL PROFESSIONAL, LLP |
NPI Number: | 1699911081 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHAD J MURDOCK (OWNER/DIRECTOR) |
Mailing Address: | 11605 Meridian Market Vw Ste 154 Falcon |
State: | CO US |
Postal Code: | 808318238 |
Phone Number: | 7194958989 |
Fax Number: | |
NPI Enumeration Date: | 01/06/2009 |
NPI Last Update Date: | 01/06/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |