Provider Demographics
NPI:1518690429
Name:RABBIT EARS PLLC
Entity Type:Organization
Organization Name:RABBIT EARS PLLC
Other - Org Name:A KIDZ DENTIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KOLBY
Authorized Official - Middle Name:
Authorized Official - Last Name:LANCE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:435-790-4170
Mailing Address - Street 1:1560 PINE GROVE RD STE C
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-8004
Mailing Address - Country:US
Mailing Address - Phone:970-879-7976
Mailing Address - Fax:
Practice Address - Street 1:1560 PINE GROVE RD STE C
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-8004
Practice Address - Country:US
Practice Address - Phone:970-879-7976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-07
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty