Dethloff, Andrew Wilson

Dethloff, Andrew Wilson is an sole proprietor health care provider with primary practice located at 1777 Lake Woodmoor Dr , Monument CO 80132-9074. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Dethloff, Andrew Wilson can be contacted via phone (719) 488-3014.

Contact Information

Primary practice address
1777 Lake Woodmoor Dr Monument CO 80132-9074
Phone: (719) 488-3014
Fax: (719) 488-3015
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 00204282 Colorado

Profile Details

NPI number 1548893928
LBN Legal business name Dethloff, Andrew Wilson
Credentials DDS. MA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 13th, 2020
Last updated Jan 26th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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