Individual
DR. SCOTT WAYNE HIRSBRUNNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3952 N ACADEMY BLVD, COLORADO SPRINGS, CO 80917-5923
(719) 591-1811
(719) 591-2032
Mailing address
3952 N ACADEMY BLVD, COLORADO SPRINGS, CO 80917-5923
(719) 591-1811
(719) 591-2032
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
00203761
CO
1223G0001X
General Practice Dentistry
D009859
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000173303
—
CO
Enumeration date
08/28/2017
Last updated
08/01/2019
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