Provider Demographics
NPI:1497412639
Name:CLEAR DENTAL CARE PLLC
Entity Type:Organization
Organization Name:CLEAR DENTAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-815-6902
Mailing Address - Street 1:7562 S UNIVERSITY BLVD STE J
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-3160
Mailing Address - Country:US
Mailing Address - Phone:303-770-8278
Mailing Address - Fax:
Practice Address - Street 1:7562 S UNIVERSITY BLVD STE J
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-3160
Practice Address - Country:US
Practice Address - Phone:303-770-8278
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-23
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental