Provider Demographics
NPI:1609231968
Name:DENNIS P. DRISCOLL DDS
Entity Type:Organization
Organization Name:DENNIS P. DRISCOLL DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:P
Authorized Official - Last Name:DRISCOLL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:719-252-1822
Mailing Address - Street 1:8225 LAGO VISTAS BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81019
Mailing Address - Country:US
Mailing Address - Phone:719-252-1822
Mailing Address - Fax:719-676-3306
Practice Address - Street 1:129 KANSAS AVE
Practice Address - Street 2:
Practice Address - City:WALSENBRUG
Practice Address - State:CO
Practice Address - Zip Code:81089
Practice Address - Country:US
Practice Address - Phone:719-252-1822
Practice Address - Fax:719-676-3306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty