South Pueblo Dental Partners LLP

NPI #1356549950 in Pueblo, Colorado

Provider Information

NPI Number: 1356549950
Entity Type: Organization
Organization Name: South Pueblo Dental Partners LLP
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 5, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1221 S PUEBLO BLVD
City: Pueblo
State: Colorado
ZIP Code: 81005-1507
Phone: (719) 565-2274

Authorized Official

Name: MR. RUSSELL A POOLE, DMD
Title: DOCTOR PARTNER
Phone: (719) 565-2274

Specialties & Taxonomy Codes

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

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