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General NPI Number Information
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NPI Number | 1992686513
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Entity Type | Organization
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Legal Business Name | MICHAEL D WONNACOTT DDS PC
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Dates
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Enumeration Date | 09/10/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 881 REAGAN HTS
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City | COLORADO SPRINGS
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State | CO
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Zip | 80921-2313
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Country | US
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Telephone | 719-488-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 881 REAGAN HTS
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City | COLORADO SPRINGS
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State | CO
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Zip | 80921-2313
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Country | US
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Telephone | 719-488-2222
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL DAVID WONNACOTT
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Credential | DDS
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Telephone | 719-466-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State |
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