Healthcare Provider Details

I. General information

NPI: 1982922894
Provider Name (Legal Business Name): JANELLE LYNN TONN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANELLE LYNN PETERSON

II. Dates (important events)

Enumeration Date: 05/17/2010
Last Update Date: 06/11/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7505 MULBERRY WOOD DR., STE 150
COLORADO SPRINGS CO
80908
US

IV. Provider business mailing address

7505 MULBERRY WOOD DR., STE 150
COLORADO SPRINGS CO
80908
US

V. Phone/Fax

Practice location:
  • Phone: 719-638-7673
  • Fax: 719-424-4928
Mailing address:
  • Phone: 719-638-7673
  • Fax: 719-424-4928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number10761
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: