Provider Demographics
NPI:1811086325
Name:KILLEBREW, JAMES EDWARD (DDS MS LLC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:KILLEBREW
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Gender:M
Credentials:DDS MS LLC
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Mailing Address - Street 1:703 N TEJON
Mailing Address - Street 2:SUITE E
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903
Mailing Address - Country:US
Mailing Address - Phone:718-635-9610
Mailing Address - Fax:719-635-5072
Practice Address - Street 1:703 N TEJON
Practice Address - Street 2:SUITE E
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903
Practice Address - Country:US
Practice Address - Phone:718-635-9610
Practice Address - Fax:719-635-5072
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO68331223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics