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Organization

DENTERUS DENTAL LAB

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL ROBERT BULL DDS (OWNER)
(719) 301-5300
Entity
Organization

Contact information

Practice address
3208 N ACADEMY BLVD, SUITE 140, COLORADO SPRINGS, CO 80917-5161
(719) 301-5300
(719) 301-5303
Mailing address
3208 N ACADEMY BLVD, SUITE 140, COLORADO SPRINGS, CO 80917-5161
(719) 301-5300
(719) 301-5303

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
00201875
CO

Other

Enumeration date
12/31/2015
Last updated
12/31/2015
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