Provider Demographics
NPI:1205080751
Name:COVAL, DANIELLE D (DDS)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:D
Last Name:COVAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:D
Other - Last Name:SCHWARTZENBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:177 CLARKSLEY RD
Mailing Address - Street 2:
Mailing Address - City:MANITOU SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80829-2725
Mailing Address - Country:US
Mailing Address - Phone:720-254-1802
Mailing Address - Fax:
Practice Address - Street 1:1920 VINDICATOR DR STE 211
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-3625
Practice Address - Country:US
Practice Address - Phone:719-314-2088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-11
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9627122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9627OtherDENTAL LICENSE
CO89936337Medicaid
COFS3479361OtherDEA