Organization
DOWN TO EARTH DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA L. CHILDRESS (OFFICE MGR.)
(719) 546-0404
Entity
Organization
Contact information
Practice address
1407 W 29TH ST, PUEBLO, CO 81008-1269
(719) 546-0404
(719) 546-0408
Mailing address
1407 W 29TH ST, PUEBLO, CO 81008-1269
(719) 546-0404
(719) 546-0408
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
CO
124Q00000X
Dental Hygienist
Primary
3009
CO
Other
Enumeration date
07/13/2009
Last updated
08/30/2016
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