AVALON DENTISTRY P.C. - NPI 1104020395

Q: What is the provider's specialty?

The provider's specialty is Dentist with taxonomy code 1223G0001X and a focus in General Practice.

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About Avalon Dentistry P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AVALON DENTISTRY P.C. (NPI 1104020395) is a healthcare organization registered as a general practice in Alamosa, Colorado and active in the NPI registry since June 2007. The organization lists Denise M Vandewalle, Owner, as its authorized official.

NPPES Registry Identity

NPI1104020395

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameAVALON DENTISTRY P.C.

Location Address815 WEST AVEAlamosa, CO 81101-3028

Mailing Address815 West AveAlamosa, CO 81101-3028 · (719) 589-4771

Phone(719) 589-4771

Organization SubpartNo

Authorized OfficialDenise M VandewalleOwner · (719) 589-4771

Enumeration DateJune 12, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1104020395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CO · 10535

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

815 WEST AVE, Alamosa, CO 81101

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DENISE MARIE VANDEWALLE DDS

Dentist (General Practice)