Organization
HOUSE FAMILY DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK HOUSE (PRESIDENT)
(719) 924-8623
Entity
Organization
Contact information
Practice address
1227 S 9TH ST, CANON CITY, CO 81212-4211
(719) 924-8623
Mailing address
1227 S 9TH ST, CANON CITY, CO 81212-4211
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
106275
CO
Other
Enumeration date
04/04/2013
Last updated
04/04/2013
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