MEDICARE: SAUNDERS DENTURE CLINIC

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
1	284300000X	Special Hospital	04400	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932360211
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAUNDERS DENTURE CLINIC

Provider Business Mailing Address
First Line	:	2047 COLUMBIA LN
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81005-3279
Country	:	US
Telephone Number	:	719-544-6787
Fax Number	:	719-564-1301

Provider Business Practice Location Address
First Line	:	2047 COLUMBIA LN
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81005-3279
Country	:	US
Telephone Number	:	719-544-6787
Fax Number	:	719-564-1301

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. CHERYL L HOWLETT-LOCKARD
Credential	:
Telephone Number	:	719-544-6787

Provider Enumeration Date	:	06/19/2008
Last Update Date	:	06/19/2008

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Directions to “SAUNDERS DENTURE CLINIC ” Practice Location

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