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Individual

DR. EDWARD ANTHONY KODITEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
230 CHATHAM DR, COLORADO SPRINGS, CO 80906-4868
(719) 576-8985
Mailing address
230 CHATHAM DR, COLORADO SPRINGS, CO 80906-4868
(719) 576-8985

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
7696
CO
122300000X
Dentist
Primary
DEN.00007696
CO
1223G0001X
General Practice Dentistry
24563
CA
1223G0001X
General Practice Dentistry
DEN-7696
CO

Other

Enumeration date
05/06/2006
Last updated
05/15/2015
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