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General NPI Number Information
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NPI Number | 1457716938
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Entity Type | Organization
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Legal Business Name | ADVANCED DENTAL SOLUTIONS PC
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Dates
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Enumeration Date | 12/28/2015
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Last Update Date | 12/28/2015
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Provider Practice Location Address
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Address Line | 500 KENNEDY DR
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City | RANGELY
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State | CO
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Zip | 81648-3502
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Country | US
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Telephone | 303-507-6959
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Fax | 970-675-3355
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Provider Business Mailing Address
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Address Line | 500 KENNEDY DR
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City | RANGELY
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State | CO
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Zip | 81648-3502
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Country | US
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Telephone | 303-507-6959
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Fax | 970-675-3355
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Authorized Official
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Title or Position | DDS
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Name | KEVIN ZUNDEL DAWSON
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Credential |
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Telephone | 303-507-6959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 8857
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License Number State | CO
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