Provider Demographics
NPI:1366085292
Name:ESPIRE DENTAL PRACTICE, LLC
Entity type:Organization
Organization Name:ESPIRE DENTAL PRACTICE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-810-6443
Mailing Address - Street 1:7995 E. PRENTICE AVENUE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2713
Mailing Address - Country:US
Mailing Address - Phone:720-699-8206
Mailing Address - Fax:720-724-9000
Practice Address - Street 1:8080 E UNION AVENUE
Practice Address - Street 2:SUITE 140
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-3614
Practice Address - Country:US
Practice Address - Phone:303-745-3182
Practice Address - Fax:720-724-9000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-23
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty