Individual
EVA COUNSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5430 TUTT BLVD, COLORADO SPRINGS, CO 80922-2515
(719) 380-0141
Mailing address
4109 10TH AVE S, MINNEAPOLIS, MN 55407-3203
(262) 374-2111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN.00205083
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/06/2021
Last updated
07/09/2022
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