MEDICARE: DR. ROBERT FAUS ANDRUS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	8161	CO

General Provider Information

NPI Number	:	1114929627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT FAUS ANDRUS DDS

Provider Business Mailing Address
First Line	:	3318 APOGEE VW
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4046
Country	:	US
Telephone Number	:	303-884-5727
Fax Number	:

Provider Business Practice Location Address
First Line	:	1803 B ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-5303
Country	:	US
Telephone Number	:	719-576-1730
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	08/22/2023

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