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Contact Information

BRAD BURTWISTLE DDS, PC
325 2ND ST STE A
MONUMENT, CO80132-7935
 Phone: 719-481-4949
 Fax: 719-481-4989
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Dental Assistant

126800000X
 

Dental Hygienist

124Q00000X
Indicates primary specialty

NPI Profile & details for BRAD BURTWISTLE DDS, PC

NPI # 1558774521
LBN Legal business name BRAD BURTWISTLE DDS, PC
Authorized official BRAD BURTWISTLE - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/08/2014
Last updated 06/08/2014 - About 12 years ago
Identifiers
CO License # 202045
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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