Individual
DR. JAMES KELLAN VILLALON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MPH
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
(719) 286-0733
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
11742
CT
122300000X
Dentist
203024
CO
1223D0004X
Dental Anesthesiology
Primary
GEN.02786194
CO
Other
Enumeration date
08/07/2015
Last updated
12/10/2020
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