Organization
PAUL ANDREATTA D.D.S.P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL A. ANDREATTA D.D.S. (OWNER/DENTIST)
(719) 846-4028
Entity
Organization
Contact information
Practice address
1723 E. MAIN ST., TRINIDAD, CO 81082
(719) 846-4028
(719) 845-0097
Mailing address
1723 E. MAIN ST., TRINIDAD, CO 81082
(719) 846-4028
(719) 845-0097
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AETNA HEALTH PLAN UP
AETNA HEALTH UPS
CO
01
—
BLUE CROSS BLUE SHIE
BLUE CROSS BLUE SHIELD
CO
01
—
DELTA DENTAL
DELTA DENTAL
CO
Enumeration date
09/26/2006
Last updated
08/22/2020
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