Organization
SAN JUAN BASIN HEALTH DEPARTMENT
Active
Parent organization
SAN JUAN BASIN HEALTH DEPARTMENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAN JUAN BASIN HEALTH DEPARTMENT
Authorized official
MS. LIANE JOLLON RN (EXECUTIVE DIRECTOR)
(970) 247-5702
Entity
Organization
Contact information
Practice address
701 CAMINO DEL RIO, SOUTHWEST SMILE MAKERS, DURANGO, CO 81301
(970) 385-4480
(970) 247-7882
Mailing address
281 SAWYER DR., DURANGO, CO 81303-3409
(970) 247-5702
(970) 247-9126
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
96635339
—
CO
Enumeration date
07/25/2006
Last updated
09/22/2014
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