| NPI | 1982249132 |
|---|---|
| Doing Business As | PLACE BRIDGE ACADEMY DENTAL SERVICE |
| Entity Type | Organization |
| Authorized Contact | ANSAR HASSAN Chief Financial Officer 303-602-7083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2023-10-03 |