Organization · NPI-2
Grand Mesa Dental Hygiene, LLC
Dental Hygienist · Delta, CO
NPI number1780034587
StatusActive
Last updated in NPPESJun 13, 2016
Details
- NPI
- 1780034587
- Entity type
- Organization (NPI-2)
- Legal business name
- Grand Mesa Dental Hygiene, LLC
- Organization subpart
- No
- Enumeration date
- Jun 13, 2016
- Last updated
- Jun 13, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 124Q00000X | Dental Hygienist | 904294 | CO | Yes |
Other names
- Grand Mesa Dental Hygiene, LLC (Doing Business As)
Practice location
417 Meeker StDelta, CO 81416-1918
Phone 970-874-3801 · Fax 970-874-3807
Mailing address
417 Meeker StDelta, CO 81416-1918
Phone 970-874-3801 · Fax 970-874-3807
Authorized official
Mary P Vigil
Owner
9708743801
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