Provider Demographics
NPI:1851455240
Name:JOHN M. TRAUL, DDS, PC
Entity Type:Organization
Organization Name:JOHN M. TRAUL, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:TRAUL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,PC
Authorized Official - Phone:970-945-8525
Mailing Address - Street 1:51241 HIGHWAY 6 STE 3
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-2577
Mailing Address - Country:US
Mailing Address - Phone:970-945-8525
Mailing Address - Fax:
Practice Address - Street 1:51241 HIGHWAY 6 STE 3
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-2577
Practice Address - Country:US
Practice Address - Phone:970-945-8525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1301223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty