Individual
DR. FRANK BURTON CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1407 W 29TH ST, PUEBLO, CO 81008
(719) 639-6448
Mailing address
2530 GREENWOOD ST, PUEBLO, CO 81003
(719) 542-0525
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3258
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78075769
—
CO
Enumeration date
02/23/2007
Last updated
07/08/2007
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