| Pagosa Peak Family Dentistry, Pllc | |
|
228 Village Dr Pagosa Springs CO 81147-8308 | |
| (216) 374-5693 | |
| Not Available |
| Full Name | Pagosa Peak Family Dentistry, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 228 Village Dr, Pagosa Springs, Colorado |
| Authorized Official Name and Position | Peter Roukema (PRESIDENT) |
| Authorized Official Contact | 2163745693 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pagosa Peak Family Dentistry, Pllc 115 Harebell Dr Pagosa Springs CO 81147-7721 Ph: (216) 374-5693 | Pagosa Peak Family Dentistry, Pllc 228 Village Dr Pagosa Springs CO 81147-8308 Ph: (216) 374-5693 |
| NPI Number | 1184377392 |
|---|---|
| Provider Enumeration Date | 01/28/2022 |
| Last Update Date | 01/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184377392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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