ROBERT C. PROVORSE

BUENA VISTA, CO
NPI1932282795
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: CO  105792)
Enumeration Date2006-10-23
Last Update Date2007-07-08
Business Address
Dr. ROBERT C. PROVORSE D.D.S.
700 HIGHWAY 24 SOUTH
BUENA VISTA, CO 81211-1305
Phone number: 719-395-8641
Mailing Address
Dr. ROBERT C. PROVORSE D.D.S.
700 HIGHWAY 24 SOUTH PO BOX 1305
BUENA VISTA, CO 81211-1305
Phone number: 719-395-8641
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