MEDICARE: HAMULA ORTHODONTICS

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	251K00000X	Public Health or Welfare Agency	5535	CO

General Provider Information

NPI Number	:	1962762955
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAMULA ORTHODONTICS

Provider Business Mailing Address
First Line	:	1860 WOODMOOR DR
Second Line	:	SUITE 200
City	:	MONUMENT
State	:	CO
Zip	:	80132-9093
Country	:	US
Telephone Number	:	719-488-3737
Fax Number	:	719-488-5971

Provider Business Practice Location Address
First Line	:	1860 WOODMOOR DR
Second Line	:	SUITE 200
City	:	MONUMENT
State	:	CO
Zip	:	80132-9093
Country	:	US
Telephone Number	:	719-488-3737
Fax Number	:	719-488-5971

Authorized Official
Title or Position	:	DDS, MSD
Name	:	DAVID W HAMULA
Credential	:	DDS, MSD
Telephone Number	:	719-487-3737

Provider Enumeration Date	:	05/23/2012
Last Update Date	:	05/23/2012

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Directions to “HAMULA ORTHODONTICS ” Practice Location

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