Provider Demographics
NPI:1497434849
Name:PERFECT TEETH - BOWMAR P.C.
Entity Type:Organization
Organization Name:PERFECT TEETH - BOWMAR P.C.
Other - Org Name:BRIDENT DENTAL SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, RCM
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-930-7707
Mailing Address - Street 1:3200 OLYMPUS BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-6149
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14401 E BAYAUD AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-1415
Practice Address - Country:US
Practice Address - Phone:303-942-8780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PERFECT TEETH- BOWMAR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-13
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental