| Pueblo West Dental, Prof.llc | |
|
120 S Stardust Dr Pueblo West CO 81007-1631 | |
| (719) 547-4474 | |
| Not Available |
| Full Name | Pueblo West Dental, Prof.llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 120 S Stardust Dr, Pueblo West, Colorado |
| Authorized Official Name and Position | Taylor Ross (MEMBER) |
| Authorized Official Contact | 3032633902 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pueblo West Dental, Prof.llc 120 S Stardust Dr Pueblo West CO 81007-1631 Ph: () - | Pueblo West Dental, Prof.llc 120 S Stardust Dr Pueblo West CO 81007-1631 Ph: (719) 547-4474 |
| NPI Number | 1891456711 |
|---|---|
| Provider Enumeration Date | 01/03/2022 |
| Last Update Date | 01/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891456711 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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