Organization
HERO DENTAL OF SPRINGS PC
Active
Parent organization
HERO DENTAL OF SPRINGS PC
Other names
Academy Kids Dental, Vision, and Orthodontics
Organization subpart
Yes
Provider details
NPI number
Legal business name
HERO DENTAL OF SPRINGS PC
Authorized official
SHAUN URBANOZO (CREDENTIALING MANAGER)
(719) 323-2362
Entity
Organization
Contact information
Practice address
3630 AUSTIN BLUFFS PKWY STE 100-120, COLORADO SPRINGS, CO 80918-6661
(719) 304-5400
Mailing address
2221 E BIJOU ST STE 100, COLORADO SPRINGS, CO 80909-8009
(719) 576-1850
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52001873
—
CO
Enumeration date
11/19/2020
Last updated
11/19/2020
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