# MINERAL COUNTY DENTAL CLINIC

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

## Provider details

- **NPI number:** 1881003002
- **Authorized official:** MR. SCOTT LAMB (COUNTY COMMISSIONER)
- **Authorized official phone:** (719) 658-2331

## Contact information

- **Practice address:** 802 RIO GRANDE AVE, CREEDE, CO 81130
- **Practice address phone:** (719) 658-0322
- **Practice address fax:** (719) 658-0322
- **Mailing address:** P.O. BOX 57, 802 RIO GRANDE AVE, CREEDE, CO 81130
- **Mailing address phone:** (719) 658-0322
- **Mailing address fax:** (719) 658-0322

## Taxonomy

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

## Other

- **Enumeration date:** 08/13/2014
- **Last updated:** 08/13/2014