Organization
MIRAGE DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JOHN MORONI JR. D.D.S. (DENTIST)
(720) 733-3440
Entity
Organization
Contact information
Practice address
755 S PERRY ST STE 200, CASTLE ROCK, CO 80104-1923
(720) 733-3440
Mailing address
85 RIO GRANDE DR., CASTLE ROCK, CO 80104
(720) 733-3440
(720) 409-4155
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7942
CO
Other
Enumeration date
07/25/2012
Last updated
02/23/2023
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