NPI | 1659702769 |
---|---|
Doing Business As | SOUTH SPRINGS DENTAL GROUP |
Entity Type | Organization |
Authorized Contact | DOUGLAS PEAK Owner/Dentist 719-494-0718 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 10397) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CO 10397) |
1223P0300X Dentist, Periodontics (Licence: CO 10397) | |
1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CO 10397) | |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 10397) | |
Enumeration Date | 2013-11-29 |
Last Update Date | 2013-11-29 |