Bright Star Kids Dentistry PLLC

Organization Active NPI General Practice Dentistry · Commerce City, CO

NPI 1043760432 · NPPES record last updated Oct 21, 2021

Key facts

NPI
1043760432
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
9842 (CO)
Legal business name
BRIGHT STAR KIDS DENTISTRY PLLC
Practice address
15200 E. 104TH Ave
Commerce City, CO 80022
Phone
(303) 286-2679
Fax
(303) 284-9687
NPI assigned
Oct 10, 2016
Organization subpart
No

Authorized official

Name
Dr. Lawrence Musanje, DDS, PHD
Title
Owner/Dentist
Phone
(303) 286-2679

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

13611 E 104th Ave
Commerce City, CO 80022
Phone (720) 588-1500

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193200000X MULTI-SPECIALTY GROUP
1223G0001X 9842 CO Yes

Addresses

Primary practice location

15200 E. 104TH Ave
Commerce City, CO 80022

Mailing address

15200 E. 104TH Ave
Commerce City, CO 80022
Phone (303) 286-2679

Other identifiers

IdentifierTypeStateIssuer
52024326MedicaidCO

Other providers in Commerce City, CO

All providers in Commerce City, CO · General Practice Dentistry in Colorado

Sources for this page

Verify at the official NPI Registry.