Provider Demographics
NPI:1366207169
Name:STETTLER KR UNION, PLLC
Entity type:Organization
Organization Name:STETTLER KR UNION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DDS
Authorized Official - Prefix:
Authorized Official - First Name:CORBAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STETTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-304-1305
Mailing Address - Street 1:3350 N UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-5757
Mailing Address - Country:US
Mailing Address - Phone:719-285-0085
Mailing Address - Fax:
Practice Address - Street 1:3350 N UNION BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-5757
Practice Address - Country:US
Practice Address - Phone:719-285-0085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty