Individual
SELISSA MANTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
302 3RD ST SE STE 150, LOVELAND, CO 80537
(970) 461-8942
(970) 292-1538
Mailing address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 350-4606
(970) 350-4645
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
1001107-15
WI
1223G0001X
General Practice Dentistry
Primary
203602
CO
Other
Enumeration date
06/26/2015
Last updated
08/22/2018
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