Organization
CAPTAIN SMILES OF GREELEY PC
Active
Other names
Adventure Dental, Vision and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUN URBANOZO (CREDENTIALING MANAGER)
(719) 323-2362
Entity
Organization
Contact information
Practice address
3485 W 10TH ST STE C, GREELEY, CO 80634-5368
(970) 353-4746
(970) 353-4751
Mailing address
2221 E BIJOU ST STE 100, COLORADO SPRINGS, CO 80909-8009
(719) 955-8896
(719) 955-3470
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
7992
CO
1223G0001X
General Practice Dentistry
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35104074
—
CO
Enumeration date
05/30/2007
Last updated
11/23/2020
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