Excellence in Dentistry of Pueblo One Pllc

NPI #1730545757 in Pueblo, Colorado

Provider Information

NPI Number: 1730545757
Entity Type: Organization
Organization Name: Excellence in Dentistry of Pueblo One Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 6, 2016
Last Updated: Jan 7, 2016

Practice Location

Address: 1800 FORTINO BLVD
Address 2: SUITE #1
City: Pueblo
State: Colorado
ZIP Code: 81008-1890
Phone: (719) 545-1400

Authorized Official

Name: MR. KENDALL B SKINNER, DDS
Title: OWNER
Phone: (303) 425-1000

Specialties & Taxonomy Codes

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

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