COMFORT DENTAL NORTH PUEBLO NPI 1457506586

NPI Information

NPI: 1457506586
Provider Name: COMFORT DENTAL NORTH PUEBLO
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
2025 US HIGHWAY 50 WEST
SUITE A100
PUEBLO, CO
ZIP 81008
Phone: (719) 542-2472
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COMFORT DENTAL NORTH PUEBLO is a dental clinic center in Pueblo, CO. COMFORT DENTAL NORTH PUEBLO NPI is 1457506586. The provider is registered as an organization entity type.

The provider's business location address is:

2025 US HIGHWAY 50 WEST
SUITE A100
PUEBLO, CO
ZIP 81008
Phone: (719) 542-2472
Fax: (719) 542-6435

The provider's authorized official is Philip Bredee Holden .
The authorized official title is Dentist and has the following contact phone number (719) 542-2472.

The enumeration date for this NPI number is 11/17/2008 and was last updated on 11/17/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	7394	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	92728375	MEDICAID	COLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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