| Glen R Dean Dds Pc | |
|
2525 North 8th Street Suite 105 Grand Junction CO 81501-8258 | |
| (970) 241-1313 | |
| (970) 241-5202 |
| Full Name | Glen R Dean Dds Pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2525 North 8th Street, Grand Junction, Colorado |
| Authorized Official Name and Position | Glen Royden Dean (PRESIDENT) |
| Authorized Official Contact | 9702411313 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glen R Dean Dds Pc 2525 North 8th Street Suite 105 Grand Junction CO 81501-8258 Ph: (970) 241-1313 | Glen R Dean Dds Pc 2525 North 8th Street Suite 105 Grand Junction CO 81501-8258 Ph: (970) 241-1313 |
| NPI Number | 1962502120 |
|---|---|
| Provider Enumeration Date | 09/25/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962502120 | NPI | - | NPPES |
| 04015236 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 104423 (Colorado) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | 1356539922 (Utah) | Secondary |
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