Organization
SOUTHERN COLORADO DENTAL ANESTHESIOLOGY
Active
Other names
Villalon Anesthesiology, SOCO Dental Anesthesia, Southern Colorado Dental Anesthesia
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES KELLAN VILLALON DDS, MPH (DENTIST ANESTHESIOLOGIST/OWNER)
(719) 286-0733
Entity
Organization
Contact information
Practice address
1225 N MAIN ST STE 207, PUEBLO, CO 81003-2857
(719) 286-0733
Mailing address
1225 N MAIN ST STE 207, PUEBLO, CO 81003-2857
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/07/2020
Last updated
09/11/2020
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