Provider Demographics
NPI:1962495507
Name:KOLZ, ARLENE JOY GODINEZ (DDS)
Entity Type:Individual
Prefix:
First Name:ARLENE JOY
Middle Name:GODINEZ
Last Name:KOLZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ARLENE JOY
Other - Middle Name:GODINEZ
Other - Last Name:TSANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:827 CHEYENNE MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4929
Mailing Address - Country:US
Mailing Address - Phone:719-579-8799
Mailing Address - Fax:719-579-6654
Practice Address - Street 1:827 CHEYENNE MEADOWS RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4929
Practice Address - Country:US
Practice Address - Phone:719-579-8799
Practice Address - Fax:719-579-6654
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA521251223G0001X
CO95611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice