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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

NPI # 1003295478
LBN Legal business name FOUR CORNERS FAMILY DENTAL-CO, LLC
Authorized official JENNIFER MANN - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 05/19/2015
Last updated 05/19/2015 - About 11 years ago
Identifiers
CO License # DEN.0000111
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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