Provider Demographics
NPI:1528189925
Name:PERFECT TEETH - UNION & ACADEMY P.C.
Entity Type:Organization
Organization Name:PERFECT TEETH - UNION & ACADEMY P.C.
Other - Org Name:PERFECT TEETH - UNION & ACADEMY P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RCM, DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-930-7707
Mailing Address - Street 1:5050 N ACADEMY BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4124
Mailing Address - Country:US
Mailing Address - Phone:719-260-6093
Mailing Address - Fax:719-260-2339
Practice Address - Street 1:5050 N ACADEMY BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4124
Practice Address - Country:US
Practice Address - Phone:719-260-6093
Practice Address - Fax:719-260-2339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO60971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty