Organization
BLACK CANYON DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL PETER REARDON DDS (OWNER/OPERATOR)
(970) 240-8880
Entity
Organization
Contact information
Practice address
1544 OXBOW DR STE 230, MONTROSE, CO 81401-5189
(970) 240-8880
(970) 240-8887
Mailing address
1544 OXBOW DR STE 230, MONTROSE, CO 81401-5189
(970) 240-8880
(970) 240-8887
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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