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General NPI Number Information
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NPI Number | 1114523099
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Entity Type | Organization
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Legal Business Name | EMBRACEKIDS II, LLC
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Dates
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Enumeration Date | 12/07/2020
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Last Update Date | 12/07/2020
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Provider Practice Location Address
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Address Line | 6390 GARDENIA STREET SUITE 200
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City | ARVADA
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State | CO
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Zip | 80004
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Country | US
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Telephone | 303-421-2616
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Fax | 303-456-4046
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Provider Business Mailing Address
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Address Line | 6390 GARDENIA STREET SUITE 200
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City | ARVADA
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State | CO
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Zip | 80004
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Country | US
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Telephone | 303-421-2616
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Fax | 303-456-4046
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Authorized Official
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Title or Position | CEO
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Name | OWEN NEIBERG
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Credential |
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Telephone | 917-224-8171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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