# COFFEE SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** All Kids Dental Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457643405
- **Authorized official:** DEVIN LARSEN (CEO)
- **Authorized official phone:** (631) 445-0593

## Contact information

- **Practice address:** 2120 19TH ST, BAKERSFIELD, CA 93301-3709
- **Practice address phone:** (661) 213-4813
- **Mailing address:** 9709 LAKESIDE BLVD STE 350, SPRING, TX 77381-1216
- **Mailing address phone:** (713) 489-2198
- **Mailing address fax:** (713) 489-2978

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | PENDING | NULL | Yes |
| 261QD0000X | Dental Clinic/Center | PENDING | NULL | — |

## Other

- **Enumeration date:** 05/10/2011
- **Last updated:** 10/15/2026