Miners Family Dental, LLC

Organization Active NPI General Practice Dentistry · Silverton, CO

NPI 1366931024 · NPPES record last updated Jun 16, 2018

Key facts

NPI
1366931024
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
DEN.00203360 (CO)
Legal business name
MINERS FAMILY DENTAL, LLC
Practice address
1315 Snowden Ste. 4B
Silverton, CO 81433
Phone
(505) 634-1501
NPI assigned
May 8, 2018
Organization subpart
No

Authorized official

Name
Mr. David Shrum, PHD
Title
Owner
Phone
(505) 634-1501

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X DEN.00203360 CO Yes

Addresses

Primary practice location

1315 Snowden Ste. 4B
Silverton, CO 81433

Mailing address

PO Box 448
Blanco, NM 87412-0448
Phone (505) 634-1505

Other identifiers

IdentifierTypeStateIssuer
000000MedicaidCO

Other providers in Silverton, CO

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

Sources for this page

Verify at the official NPI Registry.