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General NPI Number Information
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NPI Number | 1306136221
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Entity Type | Organization
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Legal Business Name | SHINING STARS KIDS DENTISTRY PC
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Dates
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Enumeration Date | 04/12/2011
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Last Update Date | 10/10/2013
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Provider Practice Location Address
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Address Line | 6999 W. ALASKA DR.
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City | LAKEWOOD
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State | CO
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Zip | 80226
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Country | US
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Telephone | 303-237-2300
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Fax | 303-237-4880
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Provider Business Mailing Address
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Address Line | 6999 W. ALASKA DR.
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City | LAKEWOOD
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State | CO
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Zip | 80226
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Country | US
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Telephone | 303-237-2300
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Fax | 303-237-4880
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. LAWRENCE MUSANJE
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Credential | DDS
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Telephone | 303-237-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9842
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License Number State | CO
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