Individual
EILEEN DORTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
883 N ACADEMY BLVD, COLORADO SPRINGS, CO 80909-8307
(840) 271-9319
Mailing address
10710 MT SPALDING LN, ENGLEWOOD, CO 80112-6436
(786) 510-2907
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN.00206107
CO
1223G0001X
General Practice Dentistry
DN23163
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/14/2015
Last updated
10/23/2024
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