Organization
PRESTIGE DENTAL PUEBLO, PLLC
Active
Other names
Prestige Dental Center South (Pueblo)
Organization subpart
No
Provider details
NPI number
Authorized official
NICK SUNDIAM (CREDENTIALING MANAGER)
(719) 300-5933
Entity
Organization
Contact information
Practice address
1700 N SALEM AVE STE B, PUEBLO, CO 81001-2861
(719) 582-4222
Mailing address
1700 N SALEM AVE STE B, PUEBLO, CO 81001-2861
(719) 582-4222
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/13/2025
Last updated
01/13/2025
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