Individual
SARA DEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2440 S ACADEMY BLVD, COLORADO SPRINGS, CO 80916-2408
(719) 576-1850
Mailing address
2440 S ACADEMY BLVD, COLORADO SPRINGS, CO 80916-2408
(719) 576-1850
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
10130
CO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
S3-71C
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100504711
—
NV
Enumeration date
10/05/2006
Last updated
07/23/2010
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