Provider Demographics
NPI:1851517221
Name:CALVIN, JAMES C
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:CALVIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 N UNION BLVD
Mailing Address - Street 2:# 100
Mailing Address - City:COLO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909
Mailing Address - Country:US
Mailing Address - Phone:719-633-2266
Mailing Address - Fax:719-578-8184
Practice Address - Street 1:1512 N UNION BLVD
Practice Address - Street 2:STE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-2884
Practice Address - Country:US
Practice Address - Phone:719-574-0181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6782122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist