IndividualActive
Justin Liddle, DMD, CDT
NPI 1154634707 · Prosthodontics · Fort Collins, CO
Provider details
- NPI number
- 1154634707
- Entity type
- Individual
- Primary specialty
- ProsthodonticsDental Providers
- Credential
- DMD, CDT
- Sex
- Male
- Sole proprietor
- No
- License
- 10142 (CO)
Specialties & taxonomies
Dental Providers
Practice location
2001 S Shields St Ste B1
Fort Collins, CO 80526-1829
Phone: (970) 224-4358
Fax: (970) 224-4388
Approximate (ZIP-level) locationGet directions
Mailing address
2001 S Shields St Ste B1
Fort Collins, CO 80526-1829
Registry dates
- Enumerated
- 2010-07-23
- Last updated
- 2010-07-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.