Individual
DR. JON GREGORY MANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
201 MERCADO ST, DURANGO, CO 81301-7301
(970) 259-1646
(970) 259-1660
Mailing address
573 FLORIDA MEADOWS LN, DURANGO, CO 81303-6646
(970) 259-5909
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7853
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7853
STATE LICENSE #
CO
Enumeration date
10/04/2006
Last updated
02/25/2014
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