Provider Demographics
NPI:1235237967
Name:VESSEL, ALICE LYNN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:LYNN
Last Name:VESSEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ALICE
Other - Middle Name:LYNN
Other - Last Name:VESSEL SINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:685 CITADEL DR E
Mailing Address - Street 2:SUITE 313
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-5314
Mailing Address - Country:US
Mailing Address - Phone:719-574-2424
Mailing Address - Fax:
Practice Address - Street 1:685 CITADEL DR E
Practice Address - Street 2:SUITE 313
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5314
Practice Address - Country:US
Practice Address - Phone:719-574-2424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8059122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist