Prestige Dental Pueblo, Pllc

NPI #1083424758 in Pueblo, Colorado

Provider Information

NPI Number: 1083424758
Entity Type: Organization
Organization Name: Prestige Dental Pueblo, Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 13, 2025
Last Updated: Jan 13, 2025

Practice Location

Address: 1700 N SALEM AVE STE B
City: Pueblo
State: Colorado
ZIP Code: 81001-2861
Phone: (719) 582-4222

Authorized Official

Name: NICK SUNDIAM
Title: CREDENTIALING MANAGER
Phone: (719) 300-5933

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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