Organization
JALA
Active
Other names
Briargate Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES BUSCH DDS (PRESIDENT)
(724) 493-3953
Entity
Organization
Contact information
Practice address
3466 BRIARGATE BLVD, COLORADO SPRINGS, CO 80920-4168
(724) 493-3953
Mailing address
3466 BRIARGATE BLVD, COLORADO SPRINGS, CO 80920-4168
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
04/08/2016
Last updated
04/08/2016
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