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General NPI Number Information
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NPI Number | 1699438861
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Entity Type | Organization
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Legal Business Name | CM DDS, PLLC
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Dates
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Enumeration Date | 10/14/2021
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Last Update Date | 10/14/2021
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Provider Practice Location Address
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Address Line | 721 N CASCADE AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80903-3211
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Country | US
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Telephone | 719-565-7388
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Fax |
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Provider Business Mailing Address
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Address Line | 10917 HIDDEN PRAIRIE PKWY
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City | FOUNTAIN
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State | CO
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Zip | 80817-7263
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Country | US
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Telephone | 719-565-7388
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CONSTANCE MADJAR
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Credential |
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Telephone | 719-565-7388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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