Organization
PALMER PARK DENTISTRY, PLLC
Active
Other names
Palmer Park Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
NICK SUNDIAM (CREDENTIALING MANAGER)
(719) 301-5300
Entity
Organization
Contact information
Practice address
3208 N ACADEMY BLVD STE 140, COLORADO SPRINGS, CO 80917-5111
(719) 301-5300
(719) 301-5303
Mailing address
3208 N ACADEMY BLVD STE 140, COLORADO SPRINGS, CO 80917-5111
(719) 301-5300
(719) 301-5303
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/30/2025
Last updated
01/30/2025
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