| Southern Colorado Orthodontic Specialists | |
|
3955 Sandalwood Ln Pueblo CO 81005-2586 | |
| (719) 564-3333 | |
| Not Available |
| Full Name | Southern Colorado Orthodontic Specialists |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3955 Sandalwood Ln, Pueblo, Colorado |
| Authorized Official Name and Position | Jae Brimhall (SOLE OWNER) |
| Authorized Official Contact | 4358817110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Colorado Orthodontic Specialists 5200 La Randa Dr Pueblo CO 81005-3532 Ph: () - | Southern Colorado Orthodontic Specialists 3955 Sandalwood Ln Pueblo CO 81005-2586 Ph: (719) 564-3333 |
| NPI Number | 1356759054 |
|---|---|
| Provider Enumeration Date | 07/25/2014 |
| Last Update Date | 07/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356759054 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | DEN.00202177 (Colorado) | 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 | |
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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 | |
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