Prestige Denture Clinic

Primary specialty

Dental LaboratoryTaxonomy code 292200000X

Legal business name

PRESTIGE DENTURE CLINIC

Practice address

1700 N Salem Ave
Suite B
Pueblo, CO 81001-2846

Phone

(719) 299-0777

Fax

(719) 582-1099

NPI assigned

Jun 26, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Daniel Roybal

Title

Owner

Phone

(719) 299-0777

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403740800000",
    "number": "1588079651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N SALEM AVE",
            "address_2": "SUITE B",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810012846",
            "telephone_number": "719-299-0777",
            "fax_number": "719-582-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N SALEM AVE",
            "address_2": "SUITE B",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810012846",
            "telephone_number": "719-299-0777",
            "fax_number": "719-582-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE DENTURE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-26",
        "last_updated": "2014-06-26",
        "status": "A",
        "authorized_official_last_name": "ROYBAL",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-299-0777"
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premium Direct Care Providers Inc.
• Prescription Shop LLC
• Prescription Shop LLC (Jim Sajbel's Prescription Shop)
• Blair Christian Presti, MD
• Prestige Dental Pueblo, PLLC (Prestige Dental Center South (Pueblo))
• Prestige Peak Medical
• Stephen Peter Prewitt, PTA
• Beverly Price
• Sara A Price, H.A.D
• Kimberly Priest, RDN

• Dental Laboratory in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Dental Laboratory in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.