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General NPI Number Information
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NPI Number | 1710863386
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Entity Type | Organization
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Legal Business Name | PREVENTATIVE DENTAL CARE
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Dates
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Enumeration Date | 08/11/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 8770 N UNION BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-7797
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Country | US
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Telephone | 719-344-2191
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Fax |
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Provider Business Mailing Address
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Address Line | 8770 N UNION BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-7797
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Country | US
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Telephone | 719-344-2191
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT HIRSBRUNNER
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Credential | DMD
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Telephone | 719-344-2191
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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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