Provider Demographics
NPI:1114108321
Name:VOSTATEK, SEAN (DDS)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:VOSTATEK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 VINDICATOR DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-3623
Mailing Address - Country:US
Mailing Address - Phone:719-598-5437
Mailing Address - Fax:
Practice Address - Street 1:1910 VINDICATOR DR
Practice Address - Street 2:SUITE 103
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-3623
Practice Address - Country:US
Practice Address - Phone:719-598-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO98841223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry