Organization
PUEBLO ENDODONTIC ASSO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REGINALD R WESTPHAL DDS MS (PRESIDENT)
(719) 544-8900
Entity
Organization
Contact information
Practice address
41 MONTEBELLO, SUITE 206, PUEBLO, CO 81001
(719) 544-8900
(719) 545-0700
Mailing address
PO BOX 9660, PUEBLO, CO 81008-9409
(719) 544-8900
(719) 545-0700
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
100988
CO
Other
Enumeration date
04/27/2007
Last updated
08/22/2020
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