Provider Demographics
NPI:1093941981
Name:NESTMAN AND ENG ORTHODONTICS, LLC
Entity Type:Organization
Organization Name:NESTMAN AND ENG ORTHODONTICS, LLC
Other - Org Name:BRIGHTON ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:WAH TEH
Authorized Official - Last Name:ENG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:319-471-1354
Mailing Address - Street 1:191 TELLURIDE ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-4355
Mailing Address - Country:US
Mailing Address - Phone:303-498-0351
Mailing Address - Fax:303-498-0367
Practice Address - Street 1:191 TELLURIDE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-4355
Practice Address - Country:US
Practice Address - Phone:303-498-0351
Practice Address - Fax:303-498-0367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9817261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental