Provider Demographics
NPI:1780844084
Name:ZIUCHKOVSKI, KIRSTEN L (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:L
Last Name:ZIUCHKOVSKI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KIRSTEN
Other - Middle Name:L
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:340 PRINTERS PKWY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3190
Mailing Address - Country:US
Mailing Address - Phone:719-630-6440
Mailing Address - Fax:719-228-6609
Practice Address - Street 1:2828 INTERNATIONAL CIR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3127
Practice Address - Country:US
Practice Address - Phone:719-475-0783
Practice Address - Fax:719-475-7478
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO87701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice