Organization
HERO VISION OF LONGMONT, LLC
Active
Other names
Adventure Dental Vision and Orthondontics
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUN URBANOZO (CREDENTIALING MANAGER)
(719) 323-2362
Entity
Organization
Contact information
Practice address
1739 N MAIN ST, LONGMONT, CO 80501-2035
(303) 834-6400
(303) 834-6414
Mailing address
2221 E BIJOU ST, STE 100, COLORADO SPRINGS, CO 80909
(303) 834-6400
(303) 834-6414
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78105081
—
CO
Enumeration date
02/04/2011
Last updated
11/23/2020
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