Healthcare Provider Details

I. General information

NPI: 1063342806
Provider Name (Legal Business Name): CLEAR DENTAL STUDIO AURORA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21400 E QUINCY AVE STE 2A
AURORA CO
80015-2803
US

IV. Provider business mailing address

2615 W 25TH AVE APT 3
DENVER CO
80211-4864
US

V. Phone/Fax

Practice location:
  • Phone: 303-656-9876
  • Fax:
Mailing address:
  • Phone: 319-621-4114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARTHA HA
Title or Position: OWNER
Credential: DDS
Phone: 319-621-4114