Organization
DOLORES COUNTY HEALTH ASSOCIATION
Active
Parent organization
DOLORES COUNTY HEALTH ASSOCIATION
Other names
Cortez Community Dental Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
DOLORES COUNTY HEALTH ASSOCIATION
Authorized official
MR. LINCOLN J PEHRSON (EXECUTIVE DIRECTOR)
(970) 677-3628
Entity
Organization
Contact information
Practice address
101 S MAPLE ST, CORTEZ, CO 81321-3562
(970) 565-1800
(970) 565-1801
Mailing address
PO BOX 576, DOVE CREEK, CO 81324-0576
(970) 677-3628
(970) 677-2540
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05682000
—
CO
Enumeration date
10/04/2018
Last updated
10/04/2018
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