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1518004274
ERIC PHILIP MEDIAVILLA
COLORADO SPRINGS, CO
NPI
1518004274
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: CO 8322)
Enumeration Date
2007-01-31
Last Update Date
2007-07-08
Business Address
Dr. ERIC PHILIP MEDIAVILLA DDS
513 KIVA RD
COLORADO SPRINGS, CO 80911-1913
Phone number: 303-588-5349
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Mailing Address
Dr. ERIC PHILIP MEDIAVILLA DDS
10036 PALISADE RIDGE DR
COLORADO SPRINGS, CO 80920-1491
Phone number: 303-588-5349
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