Organization
DENTAL HEALTH SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY B GRAVES DDS (OWNER)
(719) 542-3595
Entity
Organization
Contact information
Practice address
2099 W US HIGHWAY 50, SUITE #120, PUEBLO, CO 81008
(718) 542-3595
(719) 543-5665
Mailing address
2099 W US HIGHWAY 50, SUITE #120, PUEBLO, CO 81008
(718) 542-3595
(719) 543-5665
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6697
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02066975
—
CO
Enumeration date
08/11/2006
Last updated
08/22/2020
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