Organization
ALAMOSA FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE OLSON (REGIONAL HUMAN RESOURCE DIRECTOR)
(719) 375-1358
Entity
Organization
Contact information
Practice address
2415 MULLINS AVE UNIT 5, ALAMOSA, CO 81101-4264
(719) 991-2101
Mailing address
5731 SILVERSTONE TER STE 270, COLORADO SPRINGS, CO 80919-3545
(719) 375-1358
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
202298
CO
Other
Enumeration date
08/30/2017
Last updated
03/17/2018
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