Organization
BRIAN L SECRIST DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN L SECRIST DDS (DENTIST/OWNER)
(303) 254-4444
Entity
Organization
Contact information
Practice address
11401 WASHINGTON ST, NORTHGLENN, CO 80233-1912
(303) 254-4444
(303) 254-6552
Mailing address
11401 WASHINGTON ST, NORTHGLENN, CO 80233-1912
(303) 254-4444
(303) 254-6552
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
105294
CO
Other
Enumeration date
04/17/2015
Last updated
04/17/2015
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