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Contact Information

FOUR CORNERS FAMILY DENTAL-CO, LLC
308 N PAGOSA ST
PAGOSA SPRINGS, CO81147
 Phone: 970-507-1300
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for FOUR CORNERS FAMILY DENTAL CO LLC · (Female)

NPI Number 1003295478
Status Active
Credentials
Entity Individual
Enumeration date 05/19/2015
Last updated 05/19/2015 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • CO License # DEN.0000111
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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