Organization
BROADMOOR VALLEY DENTAL SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLIVER MORITZ SPAETH D.D.S. (PRESIDENT)
(719) 632-7636
Entity
Organization
Contact information
Practice address
2965 BROADMOOR VALLEY RD, COLORADO SPRINGS, CO 80906-4407
(719) 632-7636
(719) 632-5134
Mailing address
2965 BROADMOOR VALLEY RD, COLORADO SPRINGS, CO 80906-4407
(719) 632-7636
(719) 632-5134
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9295
CO
Other
Enumeration date
07/29/2010
Last updated
07/29/2010
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