Healthcare Provider Details

I. General information

NPI: 1396574125
Provider Name (Legal Business Name): UNION DENTAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

537 W HIGHLANDS RANCH PKWY STE 105
HIGHLANDS RANCH CO
80129-6951
US

IV. Provider business mailing address

537 W HIGHLANDS RANCH PKWY STE 105
HIGHLANDS RANCH CO
80129-6951
US

V. Phone/Fax

Practice location:
  • Phone: 303-791-4411
  • Fax:
Mailing address:
  • Phone: 303-791-4411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL HONG
Title or Position: PARTNER
Credential: DDS
Phone: 303-558-1458