Roberts, Tony Leon

Roberts, Tony Leon is an individual health care provider with primary practice located at 517 W 5Th St Ste 106, Pueblo CO 81003-3185. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Roberts, Tony Leon can be contacted via phone (719) 542-6014.

Contact Information

Primary practice address
517 W 5Th St Ste 106 Pueblo CO 81003-3185
Phone: (719) 542-6014
Fax: (719) 583-7937
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 105202 Colorado

Profile Details

NPI number 1033118815
LBN Legal business name Roberts, Tony Leon
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Aug 9th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033118815 NPPES
Colorado MEDICAID 02052025

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