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SAN JUAN DENTAL ANESTHESIA SERVICES PROFESSIONAL LLC NPI 1609250810


NPI Information

NPI: 1609250810
Provider Name: SAN JUAN DENTAL ANESTHESIA SERVICES, PROFESSIONAL LLC
Classification: Dentist - 1223D0004X
Entity Type: Organization

Specialization: Dentist Anesthesiologist

Address:
835 E 2ND AVE
SUITE 270
DURANGO, CO
ZIP 81301
Phone: (970) 247-4848
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SAN JUAN DENTAL ANESTHESIA SERVICES, PROFESSIONAL LLC is a dentist anesthesiologist dentist in Durango, CO. The provider is a dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology. SAN JUAN DENTAL ANESTHESIA SERVICES, PROFESSIONAL LLC NPI is 1609250810. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

835 E 2ND AVE
SUITE 270
DURANGO, CO
ZIP 81301-475
Phone: (970) 247-4848
Fax: (877) 888-7642

The provider's authorized official is Taylor Clark .
The authorized official title is Owner and has the following contact phone number (970) 247-4848.

The enumeration date for this NPI number is 7/17/2015 and was last updated on 7/17/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223D0004XDentistDentist Anesthesiologist201890COLORADOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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