Organization
STETTLER KR BROADMOOR PLLC
Active
Other names
Kids Rock Pediatric Dentistry and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
CORBAN STETTLER DDS (OWNER/DDS)
(719) 304-1305
Entity
Organization
Contact information
Practice address
4515 BROADMOOR BLUFFS DR, COLORADO SPRINGS, CO 80906-8647
(719) 424-4668
(719) 424-4667
Mailing address
4515 BROADMOOR BLUFFS DR, COLORADO SPRINGS, CO 80906-8647
(719) 424-4668
(719) 424-4667
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/09/2020
Last updated
07/09/2020
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