# MONTANO DDS DENTAL CENTER PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Adventure Dental, Vision and Orthodontics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053552646
- **Authorized official:** SHAUN URBANOZO (CREDENTIALING MANAGER)
- **Authorized official phone:** (719) 323-2362

## Contact information

- **Practice address:** 5632 THE ALAMEDA, BALTIMORE, MD 21239-2737
- **Practice address phone:** (410) 435-0008
- **Practice address fax:** (410) 435-0444
- **Mailing address:** 2221 E BIJOU ST, STE 100, COLORADO SPRINGS, CO 80909-8009
- **Mailing address phone:** (719) 955-8896
- **Mailing address fax:** (719) 955-3470

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | MD | Yes |
| 122300000X | Dentist | — | — | — |

## Other

- **Enumeration date:** 03/12/2009
- **Last updated:** 11/19/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 013397644 | — | MD |