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>> Dentist >> Dental Providers

Registrant NPI Number: 1326052721

Individual Registrant:
Gender: M
Not Sole Proprietor

Location and contact information for practice:
341 7TH ST  MEEKER, CO 81641 US
Tel: 970-878-3696  Fax: 970-878-3696

Contact information for business:
PO BOX 161 341 7TH ST MEEKER, CO 81641 US
Tel: 970-878-3696  Fax: 970-878-3696

Registration Information:
NPI: 1326052721
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers

Legacy codes, insurance codes and state license numbers:



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