Organization
CLARISA MANTANONA FAMILY DENTISTRY, P.C.
Active
Other names
Peregrine Family Dentistry, P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARISA KIM MANTANONA (D.D.S./PRESIDENT)
(719) 314-2088
Entity
Organization
Contact information
Practice address
1920 VINDICATOR DR, SUITE 211, COLORADO SPRINGS, CO 80919-3624
(719) 314-2088
(719) 314-2089
Mailing address
1920 VINDICATOR DR, SUITE 211, COLORADO SPRINGS, CO 80919-3624
(719) 314-2088
(719) 314-2089
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9025
CO
Other
Enumeration date
04/09/2010
Last updated
04/09/2010
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