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General NPI Number Information
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NPI Number | 1447895255
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Entity Type | Organization
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Legal Business Name | AURORA DENTIST OFFICE AND ORTHODONTICS, LLP
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Dates
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Enumeration Date | 11/15/2019
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Last Update Date | 11/15/2019
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Provider Practice Location Address
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Address Line | 12101 E DARTMOUTH AVE STE 200
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City | AURORA
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State | CO
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Zip | 80014-4948
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Country | US
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Telephone | 720-400-7325
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Fax |
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Provider Business Mailing Address
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Address Line | 17000 RED HILL AVE
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City | IRVINE
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State | CA
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Zip | 92614-5626
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Country | US
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Telephone | 714-845-8500
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Fax | 303-952-0892
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Authorized Official
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Title or Position | OWNER
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Name | SHELBY E TESAR
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Credential | DDS
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Telephone | 720-400-7325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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