Healthcare Provider Details

I. General information

NPI: 1497168223
Provider Name (Legal Business Name): JOHN-CLEEVE ANDREW SOTER D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2014
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RENEW 1-DAY DENTURES 8770 N UNION BLVD
COLORADO SPRINGS CO
80920
US

IV. Provider business mailing address

11858 E FAIR AVE
GREENWOOD VILLAGE CO
80111-5716
US

V. Phone/Fax

Practice location:
  • Phone: 719-597-8484
  • Fax: 719-597-2031
Mailing address:
  • Phone: 617-319-2530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDEN00202996
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDEN.00202996
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: