Organization
COLORADO DENTAL PROFESSIONALS, LLC
Active
Parent organization
COLORADO DENTAL PROFESSIONALS, LLC
Other names
Lodge Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLORADO DENTAL PROFESSIONALS, LLC
Authorized official
HILLARY THULL (CREDENTIALING COORDINATOR)
(217) 540-8946
Entity
Organization
Contact information
Practice address
13590 ROLLER COASTER RD, STE 100, COLORADO SPRINGS, CO 80921-2155
(719) 623-1710
(719) 623-1726
Mailing address
13590 ROLLER COASTER RD, STE 100, COLORADO SPRINGS, CO 80921-2155
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/13/2025
Last updated
03/13/2025
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