Provider Demographics
NPI:1881843936
Name:PAULUS, BRENT COLLINS (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:COLLINS
Last Name:PAULUS
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7560 RANGEWOOD DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-4199
Mailing Address - Country:US
Mailing Address - Phone:719-596-3113
Mailing Address - Fax:719-596-3254
Practice Address - Street 1:7560 RANGEWOOD DR
Practice Address - Street 2:SUITE 200
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-4199
Practice Address - Country:US
Practice Address - Phone:719-596-3113
Practice Address - Fax:719-596-3254
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-13
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101671223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics