| La Jara Dental Clinic | |
|
421 Walnut Street La Jara CO 81140 | |
| (719) 274-8948 | |
| (719) 274-8950 |
| Full Name | La Jara Dental Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 421 Walnut Street, La Jara, Colorado |
| Authorized Official Name and Position | Jania Arnoldi (PRESIDENT/CEO) |
| Authorized Official Contact | 7195895161 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Jara Dental Clinic 128 Market St Alamosa CO 81101-2290 Ph: (719) 587-1001 | La Jara Dental Clinic 421 Walnut Street La Jara CO 81140 Ph: (719) 274-8948 |
| NPI Number | 1295724797 |
|---|---|
| Provider Enumeration Date | 10/18/2005 |
| Last Update Date | 05/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295724797 | NPI | - | NPPES |
| 280030 | Other | CO | DELTA DENTAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Colorado) | Primary |