Individual
DR. ANDREW WILSON DETHLOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS. MA
Contact information
Practice address
1777 LAKE WOODMOOR DR, MONUMENT, CO 80132-9074
(719) 488-3014
(719) 488-3015
Mailing address
1777 LAKE WOODMOOR DR, MONUMENT, CO 80132-9074
(719) 488-3014
(719) 488-3015
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
00204282
CO
Other
Enumeration date
02/13/2020
Last updated
01/26/2021
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