Organization
MODERN DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA S BARCLAY (OWNER)
(970) 926-4321
Entity
Organization
Contact information
Practice address
27 MAIN ST, SUITE 104E, EDWARDS, CO 81632-8109
(970) 926-4321
Mailing address
27 MAIN ST, SUITE 104E, EDWARDS, CO 81632-8109
(970) 926-4321
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7777
CO
Other
Enumeration date
07/20/2011
Last updated
07/20/2011
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