Provider Demographics
NPI:1871035212
Name:TRANSTRUM ENDODONTICS PLLC
Entity type:Organization
Organization Name:TRANSTRUM ENDODONTICS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:TRANSTRUM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS-MS
Authorized Official - Phone:719-264-1440
Mailing Address - Street 1:9475 BRIAR VILLAGE PT.-SUITE 300
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920
Mailing Address - Country:US
Mailing Address - Phone:719-264-1440
Mailing Address - Fax:719-264-1446
Practice Address - Street 1:9475 BRIAR VILLAGE PT.-SUITE 300
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920
Practice Address - Country:US
Practice Address - Phone:719-264-1440
Practice Address - Fax:719-264-1446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-16
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty