Organization
LIFE PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH PAULSEN DDS (OWNER)
(415) 990-6229
Entity
Organization
Contact information
Practice address
4262 ROYAL PINE DR STE 100, COLORADO SPRINGS, CO 80920-2824
(719) 413-8446
Mailing address
505 N BEAR PAW LN, COLORADO SPRINGS, CO 80906-3279
(415) 990-6229
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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