# CORTEZ DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710360144
- **Authorized official:** HOWARD HASSEL PACK DMD (DENTIST)
- **Authorized official phone:** (970) 565-9569

## Contact information

- **Practice address:** 43 W MONTEZUMA AVE, CORTEZ, CO 81321-2743
- **Practice address phone:** (970) 565-9569
- **Mailing address:** 43 W MONTEZUMA AVE, CORTEZ, CO 81321-2743
- **Mailing address phone:** (970) 565-9569

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 10266 | CO | Yes |

## Other

- **Enumeration date:** 07/02/2015
- **Last updated:** 07/02/2015