Individual
CHRISTIAN RYAN EGBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2436 S ACADEMY BLVD, COLORADO SPRINGS, CO 80916-2408
(719) 391-2336
(719) 391-1625
Mailing address
2221 E BIJOU ST STE 100, COLORADO SPRINGS, CO 80909-8009
(719) 576-1850
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00204077
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DEN.00204077
CO DENTAL LICENSE
CO
Enumeration date
08/23/2019
Last updated
08/23/2019
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