Cottonwood Dental Center | |
2405 Mullins Ave Alamosa CO 81101 | |
(719) 589-5272 | |
(719) 589-5300 |
Full Name | Cottonwood Dental Center |
---|---|
Speciality | Dentist - General Practice |
Location | 2405 Mullins Ave, Alamosa, Colorado |
Authorized Official Name and Position | Darrell Gilbert Jackson (OWNER) |
Authorized Official Contact | 7195895272 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Cottonwood Dental Center 2405 Mullins Ave Alamosa CO 81101 Ph: (719) 589-5272 | Cottonwood Dental Center 2405 Mullins Ave Alamosa CO 81101 Ph: (719) 589-5272 |
NPI Number | 1588657795 |
---|---|
Provider Enumeration Date | 08/24/2005 |
Last Update Date | 08/19/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588657795 | NPI | - | NPPES |
08230064 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 8293 (Colorado) | Primary |
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