Eagle River Dentistry

NPI #1821262361 in Edwards, Colorado

Provider Information

NPI Number
1821262361
Entity Type
Organization
Organization Name
Eagle River Dentistry
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Apr 16, 2008
Last Updated
Apr 16, 2008

Practice Location

Address
0057 EDWARDS ACCESS ROAD
Address 2
SUITE 21
ZIP Code
81632-1478
Phone
(970) 926-1519

Authorized Official

Name
DR. SHELLY SUZANNE RAICHART, DDS
Title
CEO
Phone
(970) 926-1519

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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