Avalon Dentistry P.C.

Organization Active NPI General Practice Dentistry · Alamosa, CO

NPI 1104020395 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1104020395
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
10535 (CO)
Legal business name
AVALON DENTISTRY P.C.
Practice address
815 West Ave
Alamosa, CO 81101-3028
Phone
(719) 589-4771
NPI assigned
Jun 12, 2007
Organization subpart
No

Authorized official

Name
Dr. Denise M Vandewalle, D.D.S
Title
Owner
Phone
(719) 589-4771

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X 10535 CO Yes

Addresses

Primary practice location

815 West Ave
Alamosa, CO 81101-3028

Mailing address

815 West Ave
Alamosa, CO 81101-3028
Phone (719) 589-4771

Other providers in Alamosa, CO

All providers in Alamosa, CO · General Practice Dentistry in Colorado

Sources for this page

Verify at the official NPI Registry.