Pediatric Dentistry Of The Rockies Pllc
Pediatric Dental Clinic
4609 S Timberline Rd, Suite 103b, Fort Collins
Colorado, 80528-3170
970-484-4104 970-484-5245
Maps & DirectionsPediatric Dentistry Of The Rockies Pllc is a Pediatric Dental Clinic in Fort Collins, Colorado. It is located at 4609 S Timberline Rd, Suite 103b, Fort Collins, CO and its contact number is 970-484-4104. The authorized person for Pediatric Dentistry Of The Rockies Pllc is Keith Allen Van Tassell
who is President/owner of the clinic and their contact number is 970-484-4104. The primary license number for Pediatric Dentistry Of The Rockies Pllc is 9197 (Pediatric Dentistry) in Colorado.
Pediatric Dentistry Of The Rockies Pllc Clinic provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Clinic Profile:
Pediatric Dentistry Of The Rockies Pllc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Pediatric Dentistry Of The Rockies Pllc |
| Specialization: | Pediatric Dentistry |
| Clinic Address: | 4609 S Timberline Rd, Suite 103b, Fort Collins,
Colorado, 80528-3170 |
| Phone: | 970-484-4104 |
| Fax: | 970-484-5245 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Keith Allen Van Tassell |
| Position: | President/owner |
| Contact Number: | 970-484-4104 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Pediatric Dentistry Of The Rockies Pllc clinic are as mentioned below.
| NPI Number: | 1144498999 |
| NPI Enumeration Date: | 14 Feb, 2008 |
| NPI Last Update On: | 23 Oct, 2018 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Pediatric Dentistry Of The Rockies Pllc are as mentioned below.
| Specialization | License Number | State | Status | |
| Pediatric Dentistry | 9197 | Colorado | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 82906505 | Medicaid | Colorado | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Pediatric Dentistry Of The Rockies Pllc
4609 S Timberline Rd, Suite 103b
Fort Collins, Colorado |
| Zip: | 80528-3170 |
| Phone Number: | 970-484-4104 |
| Fax Number: | 970-484-5245 |
Patients can reach Pediatric Dentistry Of The Rockies Pllc at
4609 S Timberline Rd, Suite 103b, Fort Collins, Colorado or can
call to book an appointment on 970-484-4104.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.