Individual
DR. N. JARED DASTRUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
5725 ERINDALE DR STE 106, COLORADO SPRINGS, CO 80918
(719) 596-9220
(719) 574-4567
Mailing address
5725 ERINDALE DR STE 106, COLORADO SPRINGS, CO 80918-1984
(719) 596-9220
(719) 574-4567
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10185
CO
1223G0001X
General Practice Dentistry
5341183-9922
UT
Other
Enumeration date
09/11/2007
Last updated
06/22/2018
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