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NPI Code Detail

MEDICARE: DR. FRANK REDELIUS DMD

MEDICARE: DR. FRANK REDELIUS DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistDEN.00203489CO

General Provider Information

NPI Number : 1548645641
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FRANK REDELIUS DMD
Provider Business Mailing Address
First Line : 7856 CALLENDALE DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80908-5015
Country : US
Telephone Number : 954-829-6591
Fax Number :
Provider Business Practice Location Address
First Line : 11681 VOYAGER PKWY
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80921-3861
Country : US
Telephone Number : 719-574-1705
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2015
Last Update Date : 08/07/2023

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