Organization
J RYAN MICKELSON DDS, INC.
Active
Other names
Riverview Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUMMER PEERY (OFFICE MANAGER)
(970) 247-0174
Entity
Organization
Contact information
Practice address
2530 COLORADO AVE, STE 1A, DURANGO, CO 81301-4760
(970) 247-0174
(970) 382-2574
Mailing address
2530 COLORADO AVE, STE 1A, DURANGO, CO 81301-4760
(970) 247-0174
(970) 382-2574
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8630
CO
Other
Enumeration date
08/10/2011
Last updated
08/10/2011
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