Provider Demographics
NPI:1154627149
Name:TOWNSEND, HERBERT KEYES JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:KEYES
Last Name:TOWNSEND
Suffix:JR
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 1:1685 BRIARGATE BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3464
Mailing Address - Country:US
Mailing Address - Phone:719-528-7022
Mailing Address - Fax:
Practice Address - Street 1:1685 BRIARGATE BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3464
Practice Address - Country:US
Practice Address - Phone:719-528-7022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO55641223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO5564OtherCOLORADO STATE DENTAL LICENSE