Organization
TELLURIDE DENTAL PC
Active
Other names
Gary E. Conrad DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY E CONRAD DDS (DENTIST/OWNER)
97107284336
Entity
Organization
Contact information
Practice address
126 WEST COLORADO AVE, SUITE 203, TELLURIDE, CO 81435-3644
(970) 728-4336
(970) 369-4386
Mailing address
PO BOX 3644, TELLURIDE, CO 81435-3644
(970) 728-4336
(970) 369-4386
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5177
DENTAL
CO
Enumeration date
09/06/2006
Last updated
08/04/2008
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