Organization
PARK WEST DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD PADULA (MANAGER)
(719) 543-9500
Entity
Organization
Contact information
Practice address
3470 PARKER BLVD, PUEBLO, CO 81003
(719) 543-4022
Mailing address
409 N GRAND AVE, PUEBLO, CO 81003-3198
(719) 543-9500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/20/2009
Last updated
01/20/2009
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