Eagle Orthodontics, PC
Organization Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Eagle, CO
NPI 1710428883 · NPPES record last updated Mar 9, 2017
Key facts
- NPI
- 1710428883
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 22109 (TX)
- Legal business name
- EAGLE ORTHODONTICS, PC
- Practice address
- 011 Eagle Park Dr.
Eagle, CO 81631 - Phone
- (970) 328-1075
- NPI assigned
- Mar 9, 2017
- Organization subpart
- No
Authorized official
- Name
- Dr. Dustin Roden-Johnson, DDS, MS
- Title
- Owner
- Phone
- (512) 923-2041
Practitioners 1
-
Lizabeth Fanega Delacruz, D.D.S.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry |
1223X0400X | 22109 | TX | Yes |
Addresses
Primary practice location
011 Eagle Park Dr.
Eagle, CO 81631
Mailing address
PO Box 3538
Eagle, CO 81631-3538
Other names
- Eagle Orthodontics
Other providers in Eagle, CO
- Eagle County Health and Human Services
- Eagle County School District Re 50
- Eagle County School District Re 50
- Eagle Family Dentistry
- Eagle Integrated Medicine
- Eagle River Mental Wellness, PLLC
- Eagle Valley Behavioral Health
- Eagle Valley Vision, P.C.
- Susan Elizabeth Elliott
- Janet M Engle
All providers in Eagle, CO · Orthodontics and Dentofacial Orthopedics Dentistry in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.