Organization
COLORADO DENTAL PROFESSIONALS, LLC
Active
Parent organization
COLORADO DENTAL PROFESSIONALS, LLC
Other names
Broadmoor Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLORADO DENTAL PROFESSIONALS, LLC
Authorized official
HILLARY THULL (CREDENTIALING COORDINATOR)
(217) 540-8946
Entity
Organization
Contact information
Practice address
1930 S NEVADA AVE, COLORADO SPRINGS, CO 80905-3407
(719) 576-5566
Mailing address
1930 S NEVADA AVE, COLORADO SPRINGS, CO 80905-3407
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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