Organization
JADE DENTAL PROFESSIONALS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG L RODRIGUEZ (ADMINISTRATOR)
(719) 266-9393
Entity
Organization
Contact information
Practice address
6020 ERIN PARK DR STE B, COLORADO SPRINGS, CO 80918-3429
(719) 266-9393
(719) 266-9494
Mailing address
6020 ERIN PARK DR STE B, COLORADO SPRINGS, CO 80918-3429
(719) 266-9393
(719) 266-9494
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7157
CO
Other
Enumeration date
11/10/2010
Last updated
11/10/2010
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