| Advantage Dental Group | |
|
1800 Fortino Blvd Unit 1 Pueblo CO 81008-1891 | |
| (719) 545-1400 | |
| (719) 545-5153 |
| Full Name | Advantage Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 1800 Fortino Blvd Unit 1, Pueblo, Colorado |
| Authorized Official Name and Position | Eric L. Berry (OWNER) |
| Authorized Official Contact | 7195451400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advantage Dental Group 1800 Fortino Blvd Unit 1 Pueblo CO 81008-1891 Ph: (719) 545-1400 | Advantage Dental Group 1800 Fortino Blvd Unit 1 Pueblo CO 81008-1891 Ph: (719) 545-1400 |
| NPI Number | 1205276128 |
|---|---|
| Provider Enumeration Date | 06/25/2013 |
| Last Update Date | 06/25/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205276128 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 105682 (Colorado) | Primary |
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