Organization
PINE TOP ORTHODONTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (DIRECTOR OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
9475 BRIAR VILLAGE PT STE 315, COLORADO SPRINGS, CO 80920-7905
(719) 481-9199
Mailing address
9475 BRIAR VILLAGE PT STE 315, COLORADO SPRINGS, CO 80920-7905
(719) 481-9199
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
12/23/2019
Last updated
12/23/2019
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