Provider Demographics
NPI:1609393826
Name:AVANT, ARIELLE ELIZABETH (DMD)
Entity Type:Individual
Prefix:DR
First Name:ARIELLE
Middle Name:ELIZABETH
Last Name:AVANT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4430 CHIMNEY ROCK LN
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-4619
Mailing Address - Country:US
Mailing Address - Phone:719-359-1771
Mailing Address - Fax:
Practice Address - Street 1:5198 N NEVADA AVE STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-8649
Practice Address - Country:US
Practice Address - Phone:719-634-8884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2017-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.000203346122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist