| Bromley Park Dental | |
|
4700 E Bromley Ln Suite 201 Brighton CO 80601-7820 | |
| (303) 659-0667 | |
| (303) 659-5247 |
| Full Name | Bromley Park Dental |
|---|---|
| Speciality | Dentist |
| Location | 4700 E Bromley Ln, Brighton, Colorado |
| Authorized Official Name and Position | Bradley Scott Kellogg (DENTIST/MANAGER) |
| Authorized Official Contact | 3036590667 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bromley Park Dental 4700 E Bromley Ln Suite 201 Brighton CO 80601-7820 Ph: (303) 659-0667 | Bromley Park Dental 4700 E Bromley Ln Suite 201 Brighton CO 80601-7820 Ph: (303) 659-0667 |
| NPI Number | 1740440205 |
|---|---|
| Provider Enumeration Date | 06/09/2008 |
| Last Update Date | 06/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740440205 | NPI | - | NPPES |
| 44234228 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 8690 (Colorado) | Primary |
| 1223G0001X | Dentist - General Practice | 8744 (Colorado) | Secondary |
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