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General NPI Number Information
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NPI Number | 1205448107
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Entity Type | Organization
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Legal Business Name | AVOS DENTAL SPECIALISTS, PLLC
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Dates
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Enumeration Date | 08/20/2020
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Last Update Date | 08/20/2020
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Provider Practice Location Address
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Address Line | 14769 W 87TH PKWY
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City | ARVADA
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State | CO
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Zip | 80005-1454
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Country | US
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Telephone | 720-798-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 14769 W 87TH PKWY
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City | ARVADA
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State | CO
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Zip | 80005-1454
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Country | US
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Telephone | 720-798-1200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DUSTIN HAUPT
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Credential | DDS
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Telephone | 303-242-7467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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