| Cheyenne Mountain Children's Dentistry Pc | |
|
6514 S Academy Blvd Colorado Springs CO 80906-8614 | |
| (719) 442-1960 | |
| Not Available |
| Full Name | Cheyenne Mountain Children's Dentistry Pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6514 S Academy Blvd, Colorado Springs, Colorado |
| Authorized Official Name and Position | Michael J. Purcell (OWNER/DENTIST) |
| Authorized Official Contact | 7194421960 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cheyenne Mountain Children's Dentistry Pc 6514 S Academy Blvd Colorado Springs CO 80906 Ph: (719) 442-1960 | Cheyenne Mountain Children's Dentistry Pc 6514 S Academy Blvd Colorado Springs CO 80906-8614 Ph: (719) 442-1960 |
| NPI Number | 1578725743 |
|---|---|
| Provider Enumeration Date | 06/30/2008 |
| Last Update Date | 06/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578725743 | NPI | - | NPPES |
| 000789815 | Other | CO | UNITED CONCORIDA |
| 0207555 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 7055 (Colorado) | Primary |
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