Provider Demographics
NPI:1407558216
Name:ACE DENTAL TECHNOLOGY
Entity Type:Organization
Organization Name:ACE DENTAL TECHNOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:COSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DT
Authorized Official - Phone:719-329-4736
Mailing Address - Street 1:1304 N ACADEMY BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-3318
Mailing Address - Country:US
Mailing Address - Phone:719-694-9746
Mailing Address - Fax:
Practice Address - Street 1:1304 N ACADEMY BLVD STE 103
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-3318
Practice Address - Country:US
Practice Address - Phone:719-694-9746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes292200000XLaboratoriesDental Laboratory