Provider Demographics
NPI:1114929627
Name:ANDRUS, ROBERT FAUS (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FAUS
Last Name:ANDRUS
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 1:3318 APOGEE VW
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4046
Mailing Address - Country:US
Mailing Address - Phone:303-884-5727
Mailing Address - Fax:
Practice Address - Street 1:1803 B ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-5303
Practice Address - Country:US
Practice Address - Phone:719-576-1730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO81611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO10172564Medicaid