| Advantage Dental Group | |
|
1800 Fortino Blvd Suite #1 Pueblo CO 81008-1890 | |
| (719) 545-1400 | |
| Not Available |
| Full Name | Advantage Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1800 Fortino Blvd, Pueblo, Colorado |
| Authorized Official Name and Position | Kendall B Skinner (OWNER) |
| Authorized Official Contact | 3034251000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advantage Dental Group 9920 Wadsworth Pkwy Broomfield CO 80021-6847 Ph: (303) 425-1000 | Advantage Dental Group 1800 Fortino Blvd Suite #1 Pueblo CO 81008-1890 Ph: (719) 545-1400 |
| NPI Number | 1730545757 |
|---|---|
| Provider Enumeration Date | 01/06/2016 |
| Last Update Date | 01/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730545757 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10691 (Colorado) | Primary |
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