Organization
PAONIA DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FALON WAISATH DMD (PRESIDENT)
(970) 527-4853
Entity
Organization
Contact information
Practice address
402 2ND ST, PAONIA, CO 81428
(970) 527-4853
(970) 527-4855
Mailing address
PO BOX 21, PAONIA, CO 81428-0021
(970) 527-4853
(970) 527-4855
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
202094
CO
Other
Enumeration date
10/09/2013
Last updated
10/09/2013
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