Individual
TAYLOR RANDOLPH ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 S STARDUST DR, PUEBLO WEST, CO 81007-1631
(719) 547-4474
Mailing address
13006 E 17TH PLACE, UNIVERSITY OF COLORADO SCHOOL OF DENTAL MEDICINE, AURORA, CO 80045-2581
(303) 724-6496
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
00202115
CO
Other
Enumeration date
04/09/2013
Last updated
07/21/2022
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