Individual
MARY NAST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
195 W 14TH, RIFLE, CO 81650-4716
(970) 625-5200
Mailing address
463 DIAMOND A RANCH RD, CARBONDALE, CO 81623-8860
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
200994
CO
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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