| Michael J. Purcell, Dds | |
|
1640 Fortino Blvd Pueblo CO 81008-1856 | |
| (719) 543-7123 | |
| (719) 253-7761 |
| Full Name | Michael J. Purcell, Dds |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1640 Fortino Blvd, Pueblo, Colorado |
| Authorized Official Name and Position | Michael J. Purcell (OWNER/DENTIST) |
| Authorized Official Contact | 7193698484 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael J. Purcell, Dds 1640 Fortino Blvd Pueblo CO 81008-1856 Ph: (719) 543-7123 | Michael J. Purcell, Dds 1640 Fortino Blvd Pueblo CO 81008-1856 Ph: (719) 543-7123 |
| NPI Number | 1174700629 |
|---|---|
| Provider Enumeration Date | 01/28/2008 |
| Last Update Date | 01/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174700629 | NPI | - | NPPES |
| 02070555 | Medicaid | CO | |
| 789815 | Other | CO | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | C07055 (Colorado) | Primary |
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