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Organization

HERO DENTAL OF SPRINGS PC

Active
Other names
Academy Kids Dental and Vision
Organization subpart
No

Provider details

NPI number
Authorized official
SHAUN URBANOZO (CREDENTIALING MANAGER)
(719) 323-2362
Entity
Organization

Contact information

Practice address
883 N ACADEMY BLVD, COLORADO SPRINGS, CO 80909-8307
(719) 442-0071
(719) 473-5303
Mailing address
2221 E BIJOU ST STE 100, COLORADO SPRINGS, CO 80909-8009
(719) 955-8896
(719) 955-3470

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
CO
1223G0001X
General Practice Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
45275025
CO
Enumeration date
10/22/2014
Last updated
11/18/2020
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