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General NPI Number Information
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NPI Number | 1699269480
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Entity Type | Organization
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Legal Business Name | MARQUIS MOBILE DENTAL SERVICES OF COLORADO, LLC
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Dates
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Enumeration Date | 06/15/2018
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Last Update Date | 06/15/2018
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Provider Practice Location Address
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Address Line | 8234 WINDING PASSAGE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80924-8114
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Country | US
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Telephone | 901-634-2982
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 332640
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City | MURFREESBORO
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State | TN
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Zip | 37133-2640
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Country | US
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Telephone | 615-225-0938
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Fax |
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Authorized Official
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Title or Position | ASSISTANT
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Name | DR. KIMBERLY KHOO NAPPER
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Credential | PHARM. D.
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Telephone | 901-634-2982
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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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