Provider Demographics
NPI:1174006241
Name:NEO NEW EARLY ORTHODONTICS, PLLC
Entity Type:Organization
Organization Name:NEO NEW EARLY ORTHODONTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:LAUSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:303-690-0400
Mailing Address - Street 1:14991 E HAMPDEN AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3987
Mailing Address - Country:US
Mailing Address - Phone:303-690-0100
Mailing Address - Fax:
Practice Address - Street 1:9400 STATION ST STE 100
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-6814
Practice Address - Country:US
Practice Address - Phone:303-690-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty