Individual
CORY FAUTEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 SLIGO ST BLDG A, CORTEZ, CO 81321-2939
(970) 459-1314
Mailing address
111 SLIGO ST BLDG A, CORTEZ, CO 81321-2939
(970) 459-1314
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH.002024233
CO
Other
Enumeration date
11/19/2015
Last updated
11/19/2015
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