Provider Demographics
NPI:1083158349
Name:COLORADO SPRINGS DENTAL PROFESSIONALS PC
Entity Type:Organization
Organization Name:COLORADO SPRINGS DENTAL PROFESSIONALS PC
Other - Org Name:COLORADO SPRINGS SLEEP APNEA AND SNORING SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENTOWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAIRNS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-750-9244
Mailing Address - Street 1:1675 BRIARGATE BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3416
Mailing Address - Country:US
Mailing Address - Phone:719-344-9161
Mailing Address - Fax:719-213-2612
Practice Address - Street 1:1675 BRIARGATE BLVD STE C
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920
Practice Address - Country:US
Practice Address - Phone:719-344-9161
Practice Address - Fax:719-213-2612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-06
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO10609122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1245365329OtherNPI