Individual
MARK MONTANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6436 S US HIGHWAY 85-87, SUITE C, FOUNTAIN, CO 80817-1005
(719) 392-5111
(719) 392-4143
Mailing address
6436 S US HIGHWAY 85-87, SUITE C, FOUNTAIN, CO 80817-1005
(719) 392-5111
(719) 392-4143
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
202903
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39175111
—
CO
Enumeration date
08/28/2013
Last updated
03/09/2017
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