Organization
KYLEE BRIGHTSIDE DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLEE BRIGHTSIDE DDS (OWNER)
(720) 799-1445
Entity
Organization
Contact information
Practice address
1161 S PERRY ST STE B100, CASTLE ROCK, CO 80104-1978
(720) 799-1445
Mailing address
1161 S PERRY ST STE B100, CASTLE ROCK, CO 80104-1978
(720) 799-1445
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740625730
—
CO
Enumeration date
08/22/2019
Last updated
08/22/2019
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