Organization
STEPHEN M VICALVI DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN M JVICALVI DDS (OWNER)
(970) 901-9822
Entity
Organization
Contact information
Practice address
1100 E MAIN ST, STE D, MONTROSE, CO 81401-4064
(970) 240-2720
(970) 240-2724
Mailing address
1100 E MAIN ST, STE D, MONTROSE, CO 81401-4064
(970) 240-2720
(970) 240-2724
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
00007603
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99756340
—
CO
Enumeration date
09/01/2015
Last updated
09/01/2015
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