| Bright Star Kids Dentistry Pllc | |
|
15200 E. 104th Ave Commerce City CO 80022 | |
| (303) 286-2679 | |
| (303) 284-9687 |
| Full Name | Bright Star Kids Dentistry Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 15200 E. 104th Ave, Commerce City, Colorado |
| Authorized Official Name and Position | Lawrence Musanje (OWNER/DENTIST) |
| Authorized Official Contact | 3032862679 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Star Kids Dentistry Pllc 15200 E. 104th Ave Commerce City CO 80022 Ph: (303) 286-2679 | Bright Star Kids Dentistry Pllc 15200 E. 104th Ave Commerce City CO 80022 Ph: (303) 286-2679 |
| NPI Number | 1043760432 |
|---|---|
| Provider Enumeration Date | 10/10/2016 |
| Last Update Date | 10/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043760432 | NPI | - | NPPES |
| 52024326 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 9842 (Colorado) | Primary |
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