| Derose Children's Dental Clinic, Pc | |
|
1022 Liberty Ln Pueblo CO 81001-2039 | |
| (719) 545-5775 | |
| Not Available |
| Full Name | Derose Children's Dental Clinic, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1022 Liberty Ln, Pueblo, Colorado |
| Authorized Official Name and Position | Trudy Williams (DIRECTOR, LICENSING & CREDENTIALING) |
| Authorized Official Contact | 6157500342 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Derose Children's Dental Clinic, Pc 201 W 8th St Suite 810 Pueblo CO 81003-3038 Ph: (719) 562-4447 | Derose Children's Dental Clinic, Pc 1022 Liberty Ln Pueblo CO 81001-2039 Ph: (719) 545-5775 |
| NPI Number | 1699724831 |
|---|---|
| Provider Enumeration Date | 05/07/2006 |
| Last Update Date | 05/17/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699724831 | NPI | - | NPPES |
| 42852561 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Cover Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2020 S Pueblo Blvd, Pueblo, CO 81005 Phone: 719-566-0206 | |
Elmer A. Villalon, Dmd, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1225 North Main Street, #207, Pueblo, CO 81003 Phone: 719-542-7844 Fax: 719-542-7870 | |
Ronald Concialdi Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2037 Jerry Murphy Rd, Pueblo, CO 81001 Phone: 719-545-3070 Fax: 719-545-3071 | |
Park West Dental Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3470 Parker Blvd, Pueblo, CO 81003 Phone: 719-543-4022 | |
Smile Doctors Of Colorado, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 24 Club Manor Dr Ste 203, Pueblo, CO 81008 Phone: 719-417-5625 | |
Brian Scott Dds Ms Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1641 Horseshoe Dr, Pueblo, CO 81001 Phone: 719-545-2722 Fax: 719-545-7427 | |
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