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Organization
COMMUNITY DENTAL CLINIC, INC.
Active
Organization
COMMUNITY DENTAL CLINIC, INC.
Active
Other names
The PIC Place
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE HALL (EXECUTIVE DIRECTOR)
(970) 252-8896
Entity
Organization
Contact information
Practice address
87 MERCHANT DR, MONTROSE, CO 81401-3015
(970) 252-8896
(970) 240-3095
Mailing address
87 MERCHANT DR, MONTROSE, CO 81401-3015
(970) 252-8896
(970) 240-3095
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06727841
—
CO
01
—
2528896
DELTA DENTAL CHP PLUS
CO
Enumeration date
02/24/2006
Last updated
10/16/2017
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