Individual
DR. ALAN M TAKAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1630 FORTINO BLVD, PUEBLO, CO 81008-1856
(719) 545-2468
(719) 545-0815
Mailing address
1630 FORTINO BLVD, PUEBLO, CO 81008-1856
(719) 545-2468
(719) 545-0815
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
00126
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
722113
UNITED CONCORDIA
CO
01
—
78325
ANTHEM BCBS
CO
Enumeration date
12/20/2005
Last updated
01/17/2008
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