Organization
PAWEL R BIELECKI, DDS, PC
Active
Other names
Young at Heart Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL R HERRERA (BUSINESS MANAGER)
(719) 696-9009
Entity
Organization
Contact information
Practice address
2603 VINEWOOD LN, PUEBLO, CO 81005-3370
(719) 564-6464
(719) 564-1888
Mailing address
2603 VINEWOOD LN, PUEBLO, CO 81005-3370
(719) 564-6464
(719) 564-1888
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8809
CO
1223G0001X
General Practice Dentistry
9492
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83505318
—
CO
Enumeration date
04/23/2008
Last updated
10/21/2021
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