Provider Demographics
NPI:1992897672
Name:APPLETON DENTAL LLC
Entity type:Organization
Organization Name:APPLETON DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CASPER
Authorized Official - Middle Name:D
Authorized Official - Last Name:MAURER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-242-9207
Mailing Address - Street 1:2478 PATTERSON ROAD
Mailing Address - Street 2:SUITE 24
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505
Mailing Address - Country:US
Mailing Address - Phone:970-242-9207
Mailing Address - Fax:970-256-1640
Practice Address - Street 1:2478 PATTERSON ROAD
Practice Address - Street 2:SUITE 24
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505
Practice Address - Country:US
Practice Address - Phone:970-242-9207
Practice Address - Fax:970-256-1640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8815122300000X
CO7492122300000X
CO8814122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty