Colorado Dental Professionals, LLC

NPI #1093456857 in Colorado Springs, Colorado

Provider Information

NPI Number: 1093456857
Entity Type: Organization
Organization Name: Colorado Dental Professionals, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: COLORADO DENTAL PROFESSIONALS, LLC
Primary Specialty: Dentist
Enumeration Date: Apr 5, 2022
Last Updated: Apr 5, 2022

Practice Location

Address: 1930 S NEVADA AVE
City: Colorado Springs
State: Colorado
ZIP Code: 80905-3407
Phone: (719) 576-5566

Authorized Official

Name: HILLARY THULL
Title: CREDENTIALING COORDINATOR
Phone: (217) 540-8946

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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