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General NPI Number Information
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NPI Number | 1548645641
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Entity Type | Individual
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Provider Name | FRANK REDELIUS DMD
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Gender | Male
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Dates
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Enumeration Date | 07/30/2015
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 11681 VOYAGER PKWY
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City | COLORADO SPRINGS
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State | CO
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Zip | 80921-3861
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Country | US
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Telephone | 719-574-1705
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Fax |
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Provider Business Mailing Address
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Address Line | 7856 CALLENDALE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80908-5015
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Country | US
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Telephone | 954-829-6591
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN.00203489
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License Number State | CO
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