Organization
BRAD BURTWISTLE DDS, PC
Active
Other names
Monument Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRAD BURTWISTLE DDS, RN (PRESIDENT)
(719) 481-4949
Entity
Organization
Contact information
Practice address
325 2ND ST STE A, MONUMENT, CO 80132-7935
(719) 481-4949
(719) 481-4989
Mailing address
PO BOX 492, MONUMENT, CO 80132-0492
(719) 481-4949
(719) 481-4989
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
202045
CO
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
06/08/2014
Last updated
06/08/2014
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