Healthcare Provider Details

I. General information

NPI: 1366064032
Provider Name (Legal Business Name): CARE DENTAL SURGICAL CENTER OF DENVER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2020
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 S ABILENE CT
AURORA CO
80012-4909
US

IV. Provider business mailing address

151 E 5600 S STE 100
MURRAY UT
84107-8139
US

V. Phone/Fax

Practice location:
  • Phone: 801-833-0515
  • Fax:
Mailing address:
  • Phone: 801-833-0449
  • Fax: 801-453-6748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRANDON KEHL
Title or Position: OWNER
Credential:
Phone: 801-833-0474