Pueblo Dental & Braces

NPI #1891222402 in Pueblo, Colorado

Provider Information

NPI Number: 1891222402
Entity Type: Organization
Organization Name: Pueblo Dental & Braces
Primary Specialty: Dentist
Enumeration Date: May 12, 2017
Last Updated: May 12, 2017

Practice Location

Address: 1345 S PUEBLO BLVD
City: Pueblo
State: Colorado
ZIP Code: 81005-1508
Phone: (623) 910-5569

Authorized Official

Name: MICHAEL HALL
Title: DENTIST/ OWNER
Phone: (801) 602-0691

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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