Provider Demographics
NPI:1568767234
Name:NORTH POWERS DENTAL PROFESSIONALS, LLC
Entity Type:Organization
Organization Name:NORTH POWERS DENTAL PROFESSIONALS, LLC
Other - Org Name:COMFORT DENTAL - NORTH POWERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DMD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMISON
Authorized Official - Middle Name:N
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:719-637-2079
Mailing Address - Street 1:6076 STETSON HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-3562
Mailing Address - Country:US
Mailing Address - Phone:719-637-2079
Mailing Address - Fax:719-314-1304
Practice Address - Street 1:6076 STETSON HILLS BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-3562
Practice Address - Country:US
Practice Address - Phone:719-637-2079
Practice Address - Fax:719-314-1304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty