Individual
MR. VIKASH KANCHANLAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1315 S PUEBLO BLVD, #110, PUEBLO, CO 81005-2191
(719) 564-3900
(719) 564-3901
Mailing address
1315 S PUEBLO BLVD, #110, PUEBLO, CO 81005-2191
(719) 564-3900
(719) 564-3901
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8392
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48900753
—
CO
Enumeration date
07/11/2005
Last updated
06/11/2008
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