Burdett Russell Edgren in Greeley - Orthodontics And Dentofacial Orthopedics
Burdett Russell Edgren - NPI 1720291560
Burdett Russell Edgren is a Orthodontics And Dentofacial Orthopedics in Greeley, Colorado. Burdett Russell Edgren practices all healthcare services and medical treatments related to Orthodontics And Dentofacial Orthopedics. The NPI Number for Burdett Russell Edgren is 1720291560. The last update date is 2007-07-08.
Burdett Russell Edgren's current location address is 3400 W 16th St, Greeley, Colorado. You can contact this provider via phone number 9703565900 and fax number 9703562418. The mailing address for Burdett Russell Edgren is 3400 W 16th St, Greeley, Colorado. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Burdett Russell Edgren |
|---|---|
| Address | 3400 W 16th St, Greeley, Colorado |
| Phone Number | 9703565900 |
| Fax Number | 9703562418 |
| Sole Proprietor | N |
| Credentials | DDS, MS |
NPI Number Detail
| NPI Number | 1720291560 |
|---|---|
| Provider Enumeration Date | 2007-05-08 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 3400 W 16th St |
|---|---|
| City | Greeley |
| State | Colorado (CO) |
| Post Code | 806346862 |
| Phone Number | 9703565900 |
| Fax Number | 9703562418 |
Provider's Primary Taxonomy Detail
| Speciality | Orthodontics And Dentofacial Orthopedics |
|---|---|
| Taxonomy | 1223X0400X |
| Licence No | 161 |
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Definition: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their rel |
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What is the unique identifier code issued to Burdett Russell Edgren by the Centers for Medicare & Medicaid Services?
The Burdett Russell Edgren has been assigned the NPI (National Provider Identifier) 1720291560. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Burdett Russell Edgren?
The Burdett Russell Edgren is situated at 3400 W 16Th St, in the city of Greeley, state of CO, with the zip code 806346862.
What is the Burdett Russell Edgren's specialty and taxonomy code?
The Burdett Russell Edgren's specialty is Orthodontics And Dentofacial Orthopedics, and the corresponding taxonomy code is 1223X0400X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1720291560 to Burdett Russell Edgren?
The Centers for Medicare & Medicaid Services originally issued the 1720291560 to Burdett Russell Edgren on 2007-05-08.
When was the information regarding Burdett Russell Edgren most recently updated?
The details pertaining to the Burdett Russell Edgren, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.