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Individual

JOHN MONTOYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4770 BASELINE RD STE 310, BOULDER, CO 80303
(303) 443-1895
Mailing address
4770 BASELINE RD STE 310, BOULDER, CO 80303-2669
(303) 443-1895

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9350
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1629239827
NPI
CO
Enumeration date
08/28/2008
Last updated
02/05/2019
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