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General NPI Number Information
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NPI Number | 1558165308
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Entity Type | Organization
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Legal Business Name | DRDENTAL PLLC
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 07/19/2025
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Provider Practice Location Address
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Address Line | 100 S RIDGE ST # 103
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City | BRECKENRIDGE
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State | CO
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Zip | 80424-6498
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Country | US
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Telephone | 970-768-3453
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 73
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City | BRECKENRIDGE
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State | CO
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Zip | 80424-0052
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Country | US
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Telephone | 970-453-9615
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DUSTIN RUSPINI
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Credential | DDS
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Telephone | 970-453-9615
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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 |
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License Number State |
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