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Dr. Justin Tullis, DDS
Periodontist in Colorado Springs, Colorado
NPI 1497115752

Justin Tullis is a Periodontist based in Colorado Springs, CO and is specialized in Periodontics. Justin Tullis practices in Colorado Springs, CO and has the professional credentials of DDS. The NPI Number for Justin Tullis is 1497115752 and holds a License No. (Colorado).

The current practice location address for Justin Tullis is 320 E Fontanero St Ste 307, Colorado Springs, CO and can be reached out via phone at 719-475-9023 and via fax at 719-475-9009.

Location: 320 E Fontanero St Ste 307, Colorado Springs, CO, 80907-7526
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1497115752
Provider Name
Justin Tullis
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
320 E Fontanero St Ste 307, Colorado Springs, CO, 80907-7526
Phone Number
719-475-9023
Fax Number
719-475-9009
Provider Enumeration Date
03/01/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
204256 01 CO DENTAL LICENSE NUMBER
institution
Provider Business Practice Location Address Details
Address
320 E Fontanero St Ste 307
City
Colorado Springs
State
Colorado
Zip
80907-7526
Phone Number
719-475-9023
Fax Number
719-475-9009
person
Provider Business Mailing Address Details
Address
320 E Fontanero St Ste 307
City
Colorado Springs
State
Colorado
Zip
80907-7526
Phone Number
719-475-9023
Fax Number
719-475-9009
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Periodontics
Taxonomy
1223P0300X
License No.
204256 (Colorado)
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(Missouri)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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