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Organization

LOREN SITES DDS PLLC

Active
Other names
Pueblo Dental Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LOREN SITES DDS (OWNER)
(719) 543-2271
Entity
Organization

Contact information

Practice address
4104 OUTLOOK BLVD, SUITE 138, PUEBLO, CO 81008-1670
(719) 543-2271
(719) 543-0972
Mailing address
4104 OUTLOOK BLVD, SUITE 138, PUEBLO, CO 81008-1670
(719) 543-2271
(719) 543-0972

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
9979
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
85301035
CO
Enumeration date
04/23/2014
Last updated
04/23/2014
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