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Organization
HERO DENTAL OF SANTA FE PC
Active
Organization
HERO DENTAL OF SANTA FE PC
Active
Other names
Adventure Dental, Vision and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUN URBANOZO (CREDENTIALING MANAGER)
(719) 323-2362
Entity
Organization
Contact information
Practice address
2027 CERRILLOS RD, SANTA FE, NM 87505-3269
(505) 820-1212
(505) 820-1218
Mailing address
2221 E BIJOU ST STE 100, COLORADO SPRINGS, CO 80909-8009
(719) 955-8896
(719) 955-3470
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
NM
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
NULL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61352721
—
NM
Enumeration date
07/13/2011
Last updated
09/09/2025
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