| Four Corners Family Dental-co, Llc | |
|
308 N Pagosa St Pagosa Springs CO 81147 | |
| (970) 507-1300 | |
| Not Available |
| Full Name | Four Corners Family Dental-co, Llc |
|---|---|
| Speciality | Dentist |
| Location | 308 N Pagosa St, Pagosa Springs, Colorado |
| Authorized Official Name and Position | Jennifer Mann (OFFICE MANAGER) |
| Authorized Official Contact | 5053202942 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Corners Family Dental-co, Llc 3501 N Butler Ave Ste 104 Farmington NM 87401 Ph: (505) 320-2942 | Four Corners Family Dental-co, Llc 308 N Pagosa St Pagosa Springs CO 81147 Ph: (970) 507-1300 |
| NPI Number | 1003295478 |
|---|---|
| Provider Enumeration Date | 05/19/2015 |
| Last Update Date | 05/19/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003295478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DEN.0000111 (Colorado) | Primary |
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