| Paonia Dental Pc | |
|
402 2nd St Paonia CO 81428 | |
| (970) 527-4853 | |
| (970) 527-4855 |
| Full Name | Paonia Dental Pc |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 10/09/2013 |
| Last Update Date | 10/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790112605 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 202094 (Colorado) | Primary |