Headwaters Dental Management
NPI #1255795464 in Pueblo West, Colorado
Provider Information
- NPI Number
- 1255795464
- Entity Type
- Organization
- Organization Name
- Headwaters Dental Management
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Apr 13, 2016
- Last Updated
- Apr 13, 2016
Practice Location
- Address
- 120 S STARDUST DR
- City
- Pueblo West
- State
- Colorado
- ZIP Code
- 81007-1631
- Phone
- (719) 547-4474
Authorized Official
- Name
- DR. BRADY SEFCIK
- Title
- DDS/OWNER
- Phone
- (719) 547-4474
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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