Organization
MAIN STREET DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN W LANGENFELD DDS (DENTIST)
(303) 627-5460
Entity
Organization
Contact information
Practice address
6240 S MAIN ST, SUITE 295, AURORA, CO 80016-5376
(303) 627-5460
(303) 627-5438
Mailing address
6240 S MAIN ST, SUITE 295, AURORA, CO 80016-5376
(303) 627-5460
(303) 627-5438
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
104888
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
93222858
—
CO
Enumeration date
01/18/2017
Last updated
01/18/2017
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