Individual
GRACE BURKHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1560 BONFORTE BLVD, PUEBLO, CO 81001-1601
(719) 582-5957
Mailing address
1560 BONFORTE BLVD, PUEBLO, CO 81001-1601
(719) 582-5957
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
01/07/2022
Last updated
01/07/2022
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