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NPI Code Detail

MEDICARE: ADOLPH RALPH PADULA DDS

MEDICARE:   ADOLPH RALPH PADULA  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry051116NY
21223G0001XGeneral Practice DentistryD-3858ID
31223G0001XGeneral Practice Dentistry22044OH
41223G0001XGeneral Practice Dentistry12010429AIN
51223G0001XGeneral Practice Dentistry5641OK
61223G0001XGeneral Practice Dentistry5641AZ
71223G0001XGeneral Practice Dentistry4778TNV
81223G0001XGeneral Practice Dentistry60210KS
91223G0001XGeneral Practice DentistryDD2043NM
101223G0001XGeneral Practice Dentistry1134WY
111223G0001XGeneral Practice Dentistry3209CO
121223G0001XGeneral Practice Dentistry21280MA

Other Identifiers

General Provider Information

NPI Number : 1881671436
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADOLPH RALPH PADULA DDS
Provider Business Mailing Address
First Line : 415 N GRAND AVE
Second Line :
City : PUEBLO
State : CO
Zip : 81003-3111
Country : US
Telephone Number : 719-546-3333
Fax Number : 719-546-3334
Provider Business Practice Location Address
First Line : 1022 LIBERTY LN
Second Line :
City : PUEBLO
State : CO
Zip : 81001-2039
Country : US
Telephone Number : 719-545-5778
Fax Number : 719-545-5783
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2005
Last Update Date : 07/09/2007

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Directions to “ ADOLPH RALPH PADULA DDS” Practice Location

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