Organization
IRBY DENTAL COTTAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PEGGY JO IRBY RDH (OWNER)
(719) 543-8808
Entity
Organization
Contact information
Practice address
2099 WEST ST # 50, SUITE 180, PUEBLO, CO 81008
(719) 543-8808
(719) 543-8808
Mailing address
2012 COMANCHE RD, PUEBLO, CO 81001-1405
(719) 543-8808
(719) 543-8808
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
903535
CO
Other
Enumeration date
06/20/2016
Last updated
08/03/2016
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