Healthcare Provider Details

I. General information

NPI: 1376604306
Provider Name (Legal Business Name): BREGETTA TRINACE BROWN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: B TRINACE BROWN DDS

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4143 S JULIAN WAY
DENVER CO
80236-3101
US

IV. Provider business mailing address

13034 E ELGIN DR
DENVER CO
80239-4457
US

V. Phone/Fax

Practice location:
  • Phone: 303-866-7346
  • Fax:
Mailing address:
  • Phone: 303-373-1272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License NumberHD104663
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: