Healthcare Provider Details

I. General information

NPI: 1255433488
Provider Name (Legal Business Name): KIM LEE KUHLKE DDS MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 S CLARKSON ST #400
ENGLEWOOD CO
80113
US

IV. Provider business mailing address

3601 S CLARKSON ST #400
ENGLEWOOD CO
80113
US

V. Phone/Fax

Practice location:
  • Phone: 303-789-2020
  • Fax: 303-789-4640
Mailing address:
  • Phone: 303-789-2020
  • Fax: 303-789-4640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberCO00838
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: