Black Canyon Dental

NPI #1346776408 in Montrose, Colorado

Provider Information

NPI Number: 1346776408
Entity Type: Organization
Organization Name: Black Canyon Dental
Primary Specialty: Dentist
Enumeration Date: May 11, 2017
Last Updated: May 11, 2017

Practice Location

Address: 1544 OXBOW DR STE 230
City: Montrose
State: Colorado
ZIP Code: 81401-5189
Phone: (970) 240-8880

Authorized Official

Name: DANIEL PETER REARDON, DDS
Title: OWNER/OPERATOR
Phone: (970) 240-8880

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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