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Organization
COLORADO SPRINGS SLEEP AND WELLNESS, LLC
Active
Organization
COLORADO SPRINGS SLEEP AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY BARDIN MOORE DDS (OWNER/DENTIST)
(719) 475-2511
Entity
Organization
Contact information
Practice address
595 CHAPEL HILLS DR STE 105, COLORADO SPRINGS, CO 80920-1024
(719) 475-2511
(719) 475-8425
Mailing address
595 CHAPEL HILLS DR STE 105, COLORADO SPRINGS, CO 80920-1024
(719) 475-2511
(719) 475-8425
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106234
STATE LICENSE
CO
Enumeration date
02/22/2019
Last updated
02/22/2019
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