MEDICAID DENTAL HOME

Dentist - Dental Public Health

Active Organization
NPI: 1336570167

Practice Address

2125 E LA SALLE ST
Colorado Springs, CO 80909

Phone: (719) 310-3315

Specialties

Specialty Code Primary License
Dental Hygienist 124Q00000X No 903783 (CO)
Dentist - Dental Public Health 1223D0001X Yes 8109 (CO)

Frequently Asked Questions

NPI 1336570167 is the National Provider Identifier for MEDICAID DENTAL HOME, a Dentist - Dental Public Health provider located in Colorado Springs, CO. This NPI was enumerated on December 4, 2013.

Quick Facts

NPI
1336570167
Type
Organization
Enumerated
Dec 4, 2013
Last Updated
Dec 4, 2013

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