Alan M Takaki Takaki Dental Care Center
Dentist, General Practice in Pueblo, CO. Organization (NPI-2).
NPI number1841561024
StatusActive
Last updated in NPPESJan 20, 2012
Details
- NPI
- 1841561024
- Entity type
- Organization (NPI-2)
- Legal business name
- Alan M Takaki Takaki Dental Care Center
- Organization subpart
- No
- Enumeration date
- Jan 20, 2012
- Last updated
- Jan 20, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 126 | CO | Yes |
Other names
- Takaki Dental Care Center (Former Legal Business Name)
Practice location
1630 Fortino BlvdPueblo, CO 81008-1856
Phone 719-545-2468 · Fax 719-545-0815
Mailing address
1630 Fortino BlvdPueblo, CO 81008-1856
Phone 719-545-2468 · Fax 719-545-0815
Authorized official
Alan M Takaki
Owner
7195452468
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