Organization
MOUNTAIN VALLEY KIDS DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
D. MICHAEL TOBLER (OWNER)
(303) 883-1748
Entity
Organization
Contact information
Practice address
105 EDWARDS VILLAGE BLVD., #D-202, PO BOX 41, EDWARDS, CO 81632
(303) 883-1748
Mailing address
PO BOX 805, MONTROSE, CO 81402
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
9691
CO
Other
Enumeration date
02/07/2018
Last updated
02/07/2018
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