Organization
SOUTHERN COLORADO ORTHODONTICS, PLLC
Active
Other names
Southern Colorado Orthodontic Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAE BRIMHALL DMD, MS (SOLE OWNER)
(435) 881-7110
Entity
Organization
Contact information
Practice address
3955 SANDALWOOD LN, PUEBLO, CO 81005-2586
(719) 564-3333
Mailing address
5200 LA RANDA DR, PUEBLO, CO 81005-3532
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DEN.00202177
CO
Other
Enumeration date
07/25/2014
Last updated
07/25/2014
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