Advantage Dental Group | |
1800 Fortino Blvd Unit 1 Pueblo CO 81008-1891 | |
(719) 545-1400 | |
(719) 545-5153 |
Full Name | Advantage Dental Group |
---|---|
Speciality | Dentist |
Location | 1800 Fortino Blvd Unit 1, Pueblo, Colorado |
Authorized Official Name and Position | Eric L. Berry (OWNER) |
Authorized Official Contact | 7195451400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Advantage Dental Group 1800 Fortino Blvd Unit 1 Pueblo CO 81008-1891 Ph: (719) 545-1400 | Advantage Dental Group 1800 Fortino Blvd Unit 1 Pueblo CO 81008-1891 Ph: (719) 545-1400 |
NPI Number | 1205276128 |
---|---|
Provider Enumeration Date | 06/25/2013 |
Last Update Date | 06/25/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205276128 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 105682 (Colorado) | Primary |
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