Organization
PUEBLO DENTAL SERVICES LLC
Active
Other names
Pueblo Dental and Implant Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEHRON KAZEMI DDS (OWNER)
(303) 669-8908
Entity
Organization
Contact information
Practice address
200 W 29TH ST # B, PUEBLO, CO 81008-1004
(719) 542-9374
(719) 542-9433
Mailing address
1831 BOGUS PL, COLORADO SPRINGS, CO 80921-3872
(303) 669-8908
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/24/2023
Last updated
10/24/2023
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