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General NPI Number Information
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NPI Number | 1134838782
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Entity Type | Organization
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Legal Business Name | QUARTZ DENTAL
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Dates
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Enumeration Date | 11/22/2022
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 965 N TEN MILE DR A5
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City | FRISCO
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State | CO
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Zip | 80443
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Country | US
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Telephone | 970-668-1010
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2207
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City | FRISCO
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State | CO
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Zip | 80443-2207
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Country | US
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Telephone | 970-668-1010
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. HAYLEY QUARTUCCIO
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Credential | DDS
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Telephone | 720-255-5126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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