Organization
GRAND MESA DENTAL HYGIENE, LLC
Active
Other names
Grand Mesa Dental Hygiene, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY P VIGIL RDH (OWNER)
(970) 874-3801
Entity
Organization
Contact information
Practice address
417 MEEKER ST, DELTA, CO 81416-1918
(970) 874-3801
(970) 874-3807
Mailing address
417 MEEKER ST, DELTA, CO 81416-1918
(970) 874-3801
(970) 874-3807
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
904294
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49732048
—
CO
Enumeration date
06/13/2016
Last updated
06/13/2016
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