Organization
ACADEMY LASER DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID W WINN II DDS (PRESIDENT/OWNER)
(719) 260-9000
Entity
Organization
Contact information
Practice address
6475 WALL ST, SUITE 201, COLORADO SPRINGS, CO 80918-8337
(719) 260-9000
(719) 594-9199
Mailing address
6475 WALL ST, SUITE 201, COLORADO SPRINGS, CO 80918-8337
(719) 260-9000
(719) 594-9199
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
105236
CO
Other
Enumeration date
11/16/2010
Last updated
12/29/2010
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