Provider Demographics
NPI:1659144517
Name:BROOKS, KATE MULLANY (DH)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:MULLANY
Last Name:BROOKS
Suffix:
Gender:F
Credentials:DH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 ZANG ST STE L
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-8235
Mailing Address - Country:US
Mailing Address - Phone:303-665-1281
Mailing Address - Fax:
Practice Address - Street 1:520 ZANG ST STE L
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-8235
Practice Address - Country:US
Practice Address - Phone:303-665-1281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO000905182124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist