Full Name | Pdsc Pc |
---|---|
Speciality | Dentist - General Practice |
Location | 2041 Pepper Ln, Pueblo, Colorado |
Authorized Official Name and Position | Pawel Robert Bielecki (OW) |
Authorized Official Contact | 7199248535 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Pdsc Pc 2603 Vinewood Ln Pueblo CO 81005-3370 Ph: (719) 924-8535 | Pdsc Pc 2041 Pepper Ln Pueblo CO 81005-3276 Ph: (719) 564-6464 |
NPI Number | 1154879344 |
---|---|
Provider Enumeration Date | 09/15/2016 |
Last Update Date | 09/15/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154879344 | NPI | - | NPPES |
8809 | Other | CO | STATE OF COLORADO BOARD OF EXAMINERS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 8809 (Colorado) | Primary |
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› Verified 6 days ago
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