Individual
PHILLIP EARL PONTIOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1204 MAIN ST, CANON CITY, CANON CITY, CO 81212-3506
(719) 275-2887
(719) 275-2761
Mailing address
1204 MAIN ST, CANON CITY, CANON CITY, CO 81212-3506
(719) 275-2887
(719) 275-2761
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9227
CO
Other
Enumeration date
04/11/2007
Last updated
07/08/2007
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