Organization
DANIEL A. AVANT DDS MSD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL ADAM AVANT D.D.S. (PRESIDENT)
(719) 596-1363
Entity
Organization
Contact information
Practice address
685 CITADEL DR E, SUITE 312, COLORADO SPRINGS, CO 80909-5314
(719) 596-1363
(719) 596-1571
Mailing address
685 CITADEL DR E, SUITE 312, COLORADO SPRINGS, CO 80909-5314
(719) 596-1363
(719) 596-1571
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6191
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467573592
TYPE I
CO
Enumeration date
09/15/2010
Last updated
09/15/2010
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