Organization
TABEGUACHE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL ZACHARY TANNER DDS (MANAGER)
(480) 695-1673
Entity
Organization
Contact information
Practice address
604 25 RD STE B, GRAND JUNCTION, CO 81505-1202
(970) 822-7722
Mailing address
604 25 RD STE B, GRAND JUNCTION, CO 81505-1202
(970) 822-7722
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/15/2025
Last updated
08/15/2025
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