Individual
ROBERT HATHAWAY THUESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
806 W COLORADO AVE, COLORADO SPRINGS, CO 80905-1516
(719) 500-4080
Mailing address
806 W COLORADO AVE, COLORADO SPRINGS, CO 80905-1516
(719) 500-4080
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DEN.00205636
CO
1223G0001X
General Practice Dentistry
Primary
DEN.00205636
CO
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/03/2023
Last updated
05/30/2023
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