Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

College Ave Modern Dental Practice, LLC

Organization Dentist · NPI 1205358017

College Ave Modern Dental Practice, LLC is a Dentist in Fort Collins, Colorado. Licensed in Colorado. Registered with an NPI since 2017.

Licensed in
CO
In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3617 S College Ave Unit B
Fort Collins, CO 80525-3009
Phone: (970) 233-8933
Fax: (888) 790-7062
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 10115 (CO)

Record details

NPI number1205358017
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Scott Frederick — Owner/Dentist · (970) 233-8933
Other names College Ave Modern Dental; College Ave Modern Dental
NPI enumeratedJuly 13, 2017
Last updated in NPPESJuly 21, 2022
Mailing address3617 S College Ave Unit B, Fort Collins, CO 80525-3009

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