Paonia Dental Pc | |
402 2nd St Paonia CO 81428 | |
(970) 527-4853 | |
(970) 527-4855 |
Full Name | Paonia Dental Pc |
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Speciality | Clinic/center - Dental |
Location | 402 2nd St, Paonia, Colorado |
Authorized Official Name and Position | Falon Waisath (PRESIDENT) |
Authorized Official Contact | 9705274853 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Paonia Dental Pc Po Box 21 Paonia CO 81428-0021 Ph: (970) 527-4853 | Paonia Dental Pc 402 2nd St Paonia CO 81428 Ph: (970) 527-4853 |
NPI Number | 1790112605 |
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Provider Enumeration Date | 10/09/2013 |
Last Update Date | 10/09/2013 |
Identifier | Type | State | Issuer |
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1790112605 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 202094 (Colorado) | Primary |