# BASALT DENTISTRY, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Basalt Dentistry, PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023589181
- **Authorized official:** DR. JONATHAN JAMES HAERTER DDS (DENTIST/OWNER)
- **Authorized official phone:** (970) 376-4769

## Contact information

- **Practice address:** 227 MIDLAND AVE STE C3, BASALT, CO 81621-8119
- **Practice address phone:** (970) 927-5437
- **Mailing address:** 227 MIDLAND AVE STE C3, BASALT, CO 81621-8119
- **Mailing address phone:** (970) 927-5437

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/16/2018
- **Last updated:** 04/29/2019