Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JUSTIN KIMBALL LIDDLE, DMD, CDT
ActiveDR. JUSTIN KIMBALL LIDDLE, DMD, CDT is a Pediatric Dentistry healthcare provider located in FORT COLLINS, Colorado. NPI 1154634707 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · FORT COLLINS, CO
Registration Details
- NPI Number
- 1154634707
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 23, 2010 (16.070668324103 yrs)
- Last Updated
- Jul 23, 2010
- License
-
10142 (CO)
Practice Information
- Address
-
2001 S SHIELDS ST STE B1FORT COLLINS, CO, 805261829Browse CO providers · Browse ZIP 80526
- Phone
- 9702244358
- Fax
- 9702244388
- Primary Specialty
-
Pediatric Dentistry
1223P0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.