Healthcare Provider Details

I. General information

NPI: 1841871092
Provider Name (Legal Business Name): DAVID VALENTA DDS AND MADELAINE DRISKILL DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 DOMINION WAY STE 100
COLORADO SPRINGS CO
80918-1481
US

IV. Provider business mailing address

1508 N ROYER ST
COLORADO SPRINGS CO
80907-7634
US

V. Phone/Fax

Practice location:
  • Phone: 719-388-8700
  • Fax:
Mailing address:
  • Phone: 704-288-6736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DAVID VALENTA
Title or Position: OWNER
Credential: DDS
Phone: 704-288-6736