Organization
ELMER A. VILLALON, DMD, LLC
Active
Other names
Elmer A. Villalon, DMD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELMER A. VILLALON DMD (OWNER)
(719) 542-7844
Entity
Organization
Contact information
Practice address
1225 NORTH MAIN STREET, #207, PUEBLO, CO 81003
(719) 542-7844
(719) 542-7870
Mailing address
1225 N MAIN ST STE 207, PUEBLO, CO 81003-2857
(719) 542-7844
(719) 542-7870
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02059525
—
CO
Enumeration date
11/22/2019
Last updated
11/22/2019
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