Organization
PEDIATRIC DENTAL SPECIALISTS OF WESTERN CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARI COX (OFFICE MANAGER)
(970) 639-9551
Entity
Organization
Contact information
Practice address
101 JURASSIC AVE, FRUITA, CO 81521-7705
(970) 639-9551
(970) 639-9552
Mailing address
570 CHAPARRAL DR, GRAND JUNCTION, CO 81507-9533
(970) 812-7935
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
11/16/2020
Last updated
05/07/2021
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