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
—
261QD0000X
Dental Clinic/Center
PENDING
—
Other
Enumeration date
05/10/2011
Last updated
02/26/2026
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