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General NPI Number Information
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NPI Number | 1780323162
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE CARE DENTAL
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Dates
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Enumeration Date | 06/02/2022
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 2160 HOLLOW BROOK DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-1444
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Country | US
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Telephone | 720-295-1647
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Fax |
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Provider Business Mailing Address
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Address Line | 1675 OLD ANTLERS WAY
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City | MONUMENT
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State | CO
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Zip | 80132-8095
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Country | US
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Telephone | 720-295-1647
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICHOLE ANDERSON
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Credential | DDS
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Telephone | 720-295-1647
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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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