Provider Demographics
NPI:1841281482
Name:SABADELL, CHARLES A (DDS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:A
Last Name:SABADELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 CHEYENNE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905-2423
Mailing Address - Country:US
Mailing Address - Phone:719-473-5122
Mailing Address - Fax:
Practice Address - Street 1:730 CHEYENNE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-2423
Practice Address - Country:US
Practice Address - Phone:719-473-5122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0053021223G0001X
TN53021223G0001X
CODEN002018321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice