MEDICARE: JOHN M. TRAUL, DDS, PC

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
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	130	CO

General Provider Information

NPI Number	:	1851455240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN M. TRAUL, DDS, PC

Provider Business Mailing Address
First Line	:	51241 HIGHWAY 6 STE 3
Second Line	:
City	:	GLENWOOD SPRINGS
State	:	CO
Zip	:	81601-2577
Country	:	US
Telephone Number	:	970-945-8525
Fax Number	:

Provider Business Practice Location Address
First Line	:	51241 HIGHWAY 6 STE 3
Second Line	:
City	:	GLENWOOD SPRINGS
State	:	CO
Zip	:	81601-2577
Country	:	US
Telephone Number	:	970-945-8525
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOHN M. TRAUL
Credential	:	D.D.S.,P.C.
Telephone Number	:	970-945-8525

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	08/22/2020

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