| Springs Smiles Youth Dentistry, Pc | |
|
2859 E Fountain Blvd Colorado Springs CO 80910-2312 | |
| (719) 442-0071 | |
| (719) 473-5303 |
| Full Name | Springs Smiles Youth Dentistry, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2859 E Fountain Blvd, Colorado Springs, Colorado |
| Authorized Official Name and Position | Jenell Stump (MANAGER, LICENSING & CREDENTIALING) |
| Authorized Official Contact | 6157500343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Springs Smiles Youth Dentistry, Pc 16 Arcade Unit 198747 Nashville TN 37219-1994 Ph: (615) 750-0343 | Springs Smiles Youth Dentistry, Pc 2859 E Fountain Blvd Colorado Springs CO 80910-2312 Ph: (719) 442-0071 |
| NPI Number | 1194734269 |
|---|---|
| Provider Enumeration Date | 08/06/2006 |
| Last Update Date | 07/09/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194734269 | NPI | - | NPPES |
| 04015525 | Medicaid | CO | |
| 00699235 | Other | CO | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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Co Specialty Dental Services Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 S Tejon St Ste 200, Colorado Springs, CO 80903 Phone: 719-596-3113 | |
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