Provider Demographics
NPI:1518487990
Name:BDC, LLC
Entity Type:Organization
Organization Name:BDC, LLC
Other - Org Name:BRIARGATE DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUMGARDNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:719-598-1293
Mailing Address - Street 1:7750 N UNION BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-4081
Mailing Address - Country:US
Mailing Address - Phone:719-598-1293
Mailing Address - Fax:
Practice Address - Street 1:7750 N UNION BLVD STE 101
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-4081
Practice Address - Country:US
Practice Address - Phone:719-598-1293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-26
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental