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Organization

HERO DENTAL OF SANTA FE PC

Active
Other names
Adventure Dental, Vision and Orthodontics
Organization subpart
No

Provider details

NPI number
Authorized official
SHAUN URBANOZO (CREDENTIALING MANAGER)
(719) 323-2362
Entity
Organization

Contact information

Practice address
2027 CERRILLOS RD, SANTA FE, NM 87505-3269
(505) 820-1212
(505) 820-1218
Mailing address
2221 E BIJOU ST STE 100, COLORADO SPRINGS, CO 80909-8009
(719) 955-8896
(719) 955-3470

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
NM
1223G0001X
General Practice Dentistry
Primary
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
61352721
NM
Enumeration date
07/13/2011
Last updated
09/09/2025
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