National Provider Identifier Database

MMC SPECIALTY CLINIC
Multi-Specialty


Contact Information

MMC SPECIALTY CLINIC
1900 BOISE AVE STE 210
LOVELAND, CO80538-5004
Phone: 970-635-4059
Fax:
Website:
Specialty Taxonomy Code
* Multi-Specialty 261QM1300X

* Indicates primary specialty

NPI Profile & details for MMC SPECIALTY CLINIC

NPI Number 1194753780
Legal business name
LBN
MMC SPECIALTY CLINIC
Authorized official DENNIS DAHLEN - (SR VICE PRESIDENT)
Entity Organization
Organization subpart Yes
Enumeration date 06/30/2006
Last updated 10/21/2007 - About 19 years ago
Sole proprietor1 Not specified
Identifiers
  • CO Medicaid: 64803031

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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