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General NPI Number Information
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NPI Number | 1801103965
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Entity Type | Organization
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Legal Business Name | WEST MOUNTAIN DENTAL
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Dates
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Enumeration Date | 09/09/2010
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Last Update Date | 05/20/2016
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Provider Practice Location Address
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Address Line | 141 S PURCELL BLVD SUITE 120
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City | PUEBLO WEST
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State | CO
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Zip | 81007-5121
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Country | US
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Telephone | 719-547-8338
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Fax | 719-547-8228
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Provider Business Mailing Address
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Address Line | 141 S PURCELL BLVD SUITE 120
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City | PUEBLO WEST
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State | CO
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Zip | 81007-5121
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Country | US
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Telephone | 719-547-8338
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Fax | 719-547-8228
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Authorized Official
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Title or Position | OWNER
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Name | DR. ARTHUR DEE ABERCROMBIE
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Credential | DMD
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Telephone | 719-547-8338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 00202046
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License Number State | CO
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