Organization
COMMUNITY DENTAL CLINIC, INC.
Active
Other names
The PIC Place
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE HALL (EXECUTIVE DIRECTOR)
(970) 252-8896
Entity
Organization
Contact information
Practice address
87 MERCHANT DR, MONTROSE, CO 81401-3015
(970) 252-8896
(970) 240-3095
Mailing address
87 MERCHANT DR, MONTROSE, CO 81401-3015
(970) 252-8896
(970) 240-3095
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06727841
—
CO
01
—
2528896
DELTA DENTAL CHP PLUS
CO
Enumeration date
02/24/2006
Last updated
10/16/2017
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