Healthcare Provider Details

I. General information

NPI: 1144169988
Provider Name (Legal Business Name): PRACTICE 32 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5410 POWERS CENTER PT STE 220
COLORADO SPRINGS CO
80920-7148
US

IV. Provider business mailing address

5410 POWERS CENTER PT STE 230
COLORADO SPRINGS CO
80920-7148
US

V. Phone/Fax

Practice location:
  • Phone: 719-402-3232
  • Fax: 719-402-3232
Mailing address:
  • Phone: 719-402-3232
  • Fax: 719-402-3232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State

VIII. Authorized Official

Name: CHRIS SHANNON
Title or Position: MANAGER
Credential:
Phone: 719-402-3232