# PUEBLO WEST NEIGHBORHOOD DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pueblo West Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073039756
- **Authorized official:** DR. TAYLOR R ROSS DDS (DR.)
- **Authorized official phone:** (719) 547-4474

## Contact information

- **Practice address:** 120 S STARDUST DR, PUEBLO WEST, CO 81007-1631
- **Practice address phone:** (719) 547-4474
- **Practice address fax:** (719) 547-4710
- **Mailing address:** 120 S STARDUST DR, PUEBLO WEST, CO 81007-1631
- **Mailing address phone:** (719) 547-4474
- **Mailing address fax:** (719) 547-4710

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 202115 | CO | Yes |

## Other

- **Enumeration date:** 08/15/2017
- **Last updated:** 07/21/2022