Organization
GREAT SMILE DENTAL GROUP, LLC
Active
Other names
Hansen and Amundson Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER B AMUNDSON D.M.D. (MEMBER)
(970) 249-3330
Entity
Organization
Contact information
Practice address
629 E STAR CT, MONTROSE, CO 81401-6701
(970) 249-3330
(970) 249-4171
Mailing address
629 E STAR CT, MONTROSE, CO 81401-6701
(970) 249-3330
(970) 249-4171
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7485
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04430344
—
CO
Enumeration date
01/27/2012
Last updated
04/05/2016
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