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Organization
COFFEE SURGERY CENTER, LLC
Active
Organization
COFFEE SURGERY CENTER, LLC
Active
Other names
All Kids Dental Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DEVIN LARSEN (CEO)
(631) 445-0593
Entity
Organization
Contact information
Practice address
2120 19TH ST, BAKERSFIELD, CA 93301-3709
(661) 213-4813
Mailing address
9709 LAKESIDE BLVD STE 350, SPRING, TX 77381-1216
(713) 489-2198
(713) 489-2978
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
PENDING
NULL
261QD0000X
Dental Clinic/Center
PENDING
NULL
Other
Enumeration date
05/10/2011
Last updated
10/15/2026
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