Young At Heart Dentistry in Pueblo - Pediatric Dentistry
Young At Heart Dentistry - NPI 1962615492
Young At Heart Dentistry is a Pediatric Dentistry in Pueblo, Colorado. Young At Heart Dentistry practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Young At Heart Dentistry is 1962615492. The last update date is 2008-01-18.
Young At Heart Dentistry's current location address is 2603 Vinewood Ln, Pueblo, Colorado. You can contact this provider via phone number 7195646464 and fax number 7195641818. The mailing address for Young At Heart Dentistry is 2603 Vinewood Ln, Pueblo, Colorado. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Young At Heart Dentistry |
|---|---|
| Address | 2603 Vinewood Ln, Pueblo, Colorado |
| Phone Number | 7195646464 |
| Fax Number | 7195641818 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Purcell J Michael |
| Credentials | DDS |
| Telephone Number | 7195437123 |
NPI Number Detail
| NPI Number | 1962615492 |
|---|---|
| Provider Enumeration Date | 2007-05-08 |
| Last Updated Date | 2008-01-18 |
Provider Mailing Address Detail
| Address | 2603 Vinewood Ln |
|---|---|
| City | Pueblo |
| State | Colorado (CO) |
| Post Code | 810053370 |
| Phone Number | 7195646464 |
| Fax Number | 7195641818 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 7055 |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 91284546 | CO | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Young At Heart Dentistry by the Centers for Medicare & Medicaid Services (CMS)?
The Young At Heart Dentistry has been assigned the NPI (National Provider Identifier) 1962615492. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete physical address where Young At Heart Dentistry is located?
The Young At Heart Dentistry is situated at the following address: 2603 Vinewood Ln, Pueblo, CO, 810053370.
What is Young At Heart Dentistry's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Young At Heart Dentistry is Pediatric Dentistry, and the taxonomy code that categorizes this field of expertise is 1223P0221X.
On what date did the Young At Heart Dentistry receive the assignment of its 1962615492 from the Centers for Medicare & Medicaid Services?
The Young At Heart Dentistry was issued its 1962615492 by the Centers for Medicare & Medicaid Services on 2007-05-08.
As of what date were the Young At Heart Dentistry's details last updated?
The information pertaining to the Young At Heart Dentistry, including its address, specialty, and other details, was most recently updated on 2008-01-18.
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