# ELMER A. VILLALON, DMD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Elmer A. Villalon, DMD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023654241
- **Authorized official:** DR. ELMER A. VILLALON DMD (OWNER)
- **Authorized official phone:** (719) 542-7844

## Contact information

- **Practice address:** 1225 NORTH MAIN STREET, \#207, PUEBLO, CO 81003
- **Practice address phone:** (719) 542-7844
- **Practice address fax:** (719) 542-7870
- **Mailing address:** 1225 N MAIN ST STE 207, PUEBLO, CO 81003-2857
- **Mailing address phone:** (719) 542-7844
- **Mailing address fax:** (719) 542-7870

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/22/2019
- **Last updated:** 11/22/2019