| NPI | 1740440205 |
|---|---|
| Doing Business As | BROMLEY PARK DENTAL |
| Entity Type | Organization |
| Authorized Contact | BRADLEY SCOTT KELLOGG Dentist/Manager 303-659-0667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 8690) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 8744) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-06-09 |