Provider Demographics
NPI:1952946733
Name:MUSOIF DENTAL PC
Entity Type:Organization
Organization Name:MUSOIF DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MUSOIF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:719-622-9200
Mailing Address - Street 1:6140 TUTT BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923
Mailing Address - Country:US
Mailing Address - Phone:719-622-9200
Mailing Address - Fax:719-622-9201
Practice Address - Street 1:6140 TUTT BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923
Practice Address - Country:US
Practice Address - Phone:719-622-9200
Practice Address - Fax:719-622-9201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty