Provider Demographics
NPI:1346461209
Name:DAVE F. PROIETTI,DDS, P.C.
Entity Type:Organization
Organization Name:DAVE F. PROIETTI,DDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:F
Authorized Official - Last Name:PROIETTI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-245-2826
Mailing Address - Street 1:2558 F RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1422
Mailing Address - Country:US
Mailing Address - Phone:970-245-2826
Mailing Address - Fax:970-245-3302
Practice Address - Street 1:2558 F RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1422
Practice Address - Country:US
Practice Address - Phone:970-245-2826
Practice Address - Fax:970-245-3302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO57986827Medicaid