# MICHAEL KUNKEL DDS PROFESSIONAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Oral and Facial Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376989707
- **Authorized official:** DR. MICHAEL KUNKEL D.D.S. (MANAGING MEMBER)
- **Authorized official phone:** (719) 264-6070

## Contact information

- **Practice address:** 3475 BRIARGATE BLVD, SUITE 102, COLORADO SPRINGS, CO 80920-4170
- **Practice address phone:** (719) 264-6070
- **Practice address fax:** (719) 264-6090
- **Mailing address:** 3475 BRIARGATE BLVD, SUITE 102, COLORADO SPRINGS, CO 80920-4170
- **Mailing address phone:** (719) 264-6070
- **Mailing address fax:** (719) 264-6090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DEN.00201943 | CO | Yes |

## Other

- **Enumeration date:** 05/13/2013
- **Last updated:** 05/13/2013