Organization
PUEBLO DENTAL & BRACES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL HALL (DENTIST/ OWNER)
(801) 602-0691
Entity
Organization
Contact information
Practice address
1345 S PUEBLO BLVD, PUEBLO, CO 81005-1508
(623) 910-5569
Mailing address
4542 VALLEYBROOK DR, HIGHLANDS RANCH, CO 80130-6965
(623) 910-5569
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN 202339
CO
Other
Enumeration date
05/12/2017
Last updated
05/12/2017
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