Provider Demographics
NPI:1649803537
Name:KIDS CITY DENTAL AND BRACES, PLLC
Entity type:Organization
Organization Name:KIDS CITY DENTAL AND BRACES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:TORY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:MCFARLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-591-9617
Mailing Address - Street 1:2331 PRAIRIE CENTER PKWY UNIT D
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-7037
Mailing Address - Country:US
Mailing Address - Phone:720-797-9779
Mailing Address - Fax:
Practice Address - Street 1:2331 PR CTR PKWY
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-7036
Practice Address - Country:US
Practice Address - Phone:713-591-9617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental