Organization
FRUITA CANYON DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KREHL WILLIAM STEGELMEIER D.D.S. (DENTIST)
(970) 858-8484
Entity
Organization
Contact information
Practice address
288 W PABOR AVE, FRUITA, CO 81521-2153
(970) 858-8484
(970) 858-8484
Mailing address
288 W PABOR AVE, FRUITA, CO 81521-2153
(970) 858-8484
(970) 858-6436
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8989
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16183274
—
CO
Enumeration date
06/30/2016
Last updated
06/30/2016
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