Implant & Periodontic Specialists Of Pueblo | |
2041 Pepper Ln Pueblo CO 81005-3276 | |
(719) 696-9009 | |
Not Available |
Full Name | Implant & Periodontic Specialists Of Pueblo |
---|---|
Speciality | Dentist - Periodontics |
Location | 2041 Pepper Ln, Pueblo, Colorado |
Authorized Official Name and Position | Michael Robert Herrera (BUSINESS MANAGER) |
Authorized Official Contact | 7609788527 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Implant & Periodontic Specialists Of Pueblo 2041 Pepper Ln Pueblo CO 81005-3276 Ph: (719) 696-9009 | Implant & Periodontic Specialists Of Pueblo 2041 Pepper Ln Pueblo CO 81005-3276 Ph: (719) 696-9009 |
NPI Number | 1154970366 |
---|---|
Provider Enumeration Date | 09/10/2019 |
Last Update Date | 11/12/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154970366 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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