| Blue Yonder Dental Care | |
|
9205 E. 159th Ave Brighton CO 80602-8676 | |
| (720) 836-1127 | |
| (720) 836-3322 |
| Full Name | Blue Yonder Dental Care |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 9205 E. 159th Ave, Brighton, Colorado |
| Authorized Official Name and Position | Steven Lane Combs (OWNER) |
| Authorized Official Contact | 3086313833 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Yonder Dental Care 9205 E. 159th Ave Brighton CO 80602-8676 Ph: (720) 836-1127 | Blue Yonder Dental Care 9205 E. 159th Ave Brighton CO 80602-8676 Ph: (720) 836-1127 |
| NPI Number | 1023491297 |
|---|---|
| Provider Enumeration Date | 07/06/2015 |
| Last Update Date | 02/05/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023491297 | NPI | - | NPPES |
| 932363-01 | Medicaid | CO | |
| 93236301 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DEN.00006022 (Colorado) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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