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Organization
STETTLER KR BROADMOOR PLLC
Active
Organization
STETTLER KR BROADMOOR PLLC
Active
Other names
Kids Rock Pediatric Dentistry and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
CORBAN STETTLER DDS (OWNER/DDS)
(719) 304-1305
Entity
Organization
Contact information
Practice address
4515 BROADMOOR BLUFFS DR, COLORADO SPRINGS, CO 80906-8647
(719) 424-4668
(719) 424-4667
Mailing address
4515 BROADMOOR BLUFFS DR, COLORADO SPRINGS, CO 80906-8647
(719) 424-4668
(719) 424-4667
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
NULL
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
NULL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
07/09/2020
Last updated
07/09/2020
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