BROADMOOR DENTAL LLC NPI 1295037646

NPI Information

BROADMOOR DENTAL, LLC is a general practice dentist in Colorado Springs, CO. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. BROADMOOR DENTAL, LLC NPI is 1295037646. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1930 S NEVADA AVE
COLORADO SPRINGS, CO
ZIP 80905-407
Phone: (719) 576-5566
Fax: (719) 576-1100

The provider's authorized official is Nicolas Roger Pruett .
The authorized official title is Owner/dentist and has the following contact phone number (719) 576-5566.

The enumeration date for this NPI number is 11/17/2010 and was last updated on 11/17/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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