Organization
HERO DENTAL OF COMMERCE CITY PC
Active
Other names
Adventure 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
6075 E PARKWAY DR STE 160, COMMERCE CITY, CO 80022-5413
(720) 795-7077
(719) 955-3470
Mailing address
2221 E BIJOU ST STE 100, COLORADO SPRINGS, CO 80909-8009
(719) 576-1850
(719) 955-3470
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DEN00009208
CO LICENSE
CO
Enumeration date
07/23/2019
Last updated
11/18/2020
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