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Organization

TREASURED TEETH PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DERREN ELVIS TIPPETS DMD (OWNER, PEDIATRIC DENTIST)
(970) 240-8694
Entity
Organization

Contact information

Practice address
100 TESSITORE CT UNIT C, MONTROSE, CO 81401-5689
(970) 240-8694
(970) 240-8696
Mailing address
100 TESSITORE CT UNIT C, MONTROSE, CO 81401-5689
(970) 240-8694
(970) 240-8696

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
9579
CO

Other

Enumeration date
02/18/2009
Last updated
02/18/2009
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