Healthcare Provider Details

I. General information

NPI: 1902322290
Provider Name (Legal Business Name): KHL ENTERPRISES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2017
Last Update Date: 08/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14555 E ARAPAHOE RD UNIT D
AURORA CO
80016-1584
US

IV. Provider business mailing address

667 RIDGEGLEN WAY
HIGHLANDS RANCH CO
80126-2264
US

V. Phone/Fax

Practice location:
  • Phone: 303-766-4444
  • Fax:
Mailing address:
  • Phone: 720-289-5867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. KEVIN M. VARLEY
Title or Position: OWNER
Credential: DDS
Phone: 720-289-5867