| Pueblo Endodontic Asso Llc | |
|
41 Montebello Suite 206 Pueblo CO 81001 | |
| (719) 544-8900 | |
| (719) 545-0700 |
| Full Name | Pueblo Endodontic Asso Llc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 41 Montebello, Pueblo, Colorado |
| Authorized Official Name and Position | Reginald R Westphal (PRESIDENT) |
| Authorized Official Contact | 7195448900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pueblo Endodontic Asso Llc Po Box 9660 Pueblo CO 81008-9409 Ph: (719) 544-8900 | Pueblo Endodontic Asso Llc 41 Montebello Suite 206 Pueblo CO 81001 Ph: (719) 544-8900 |
| NPI Number | 1609096999 |
|---|---|
| Provider Enumeration Date | 04/27/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609096999 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 100988 (Colorado) | Primary |
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