| Implant & Periodontic Specialists Of Pueblo | |
|
2041 Pepper Ln Pueblo CO 81005-3276 | |
| (719) 696-9009 | |
| Not Available |
| Full Name | Implant & Periodontic Specialists Of Pueblo |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 2041 Pepper Ln, Pueblo, Colorado |
| Authorized Official Name and Position | Michael Robert Herrera (BUSINESS MANAGER) |
| Authorized Official Contact | 7609788527 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Implant & Periodontic Specialists Of Pueblo 2041 Pepper Ln Pueblo CO 81005-3276 Ph: (719) 696-9009 | Implant & Periodontic Specialists Of Pueblo 2041 Pepper Ln Pueblo CO 81005-3276 Ph: (719) 696-9009 |
| NPI Number | 1154970366 |
|---|---|
| Provider Enumeration Date | 09/10/2019 |
| Last Update Date | 11/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154970366 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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