Provider Demographics
NPI:1811564966
Name:DUBLIN KIDS DENTAL GROUP AND ORTHODONTICS, LLP
Entity Type:Organization
Organization Name:DUBLIN KIDS DENTAL GROUP AND ORTHODONTICS, LLP
Other - Org Name:DUBLIN MODERN DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:W
Authorized Official - Last Name:CAIRNS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:719-359-8295
Mailing Address - Street 1:PO BOX 920050
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75392-0050
Mailing Address - Country:US
Mailing Address - Phone:719-359-8295
Mailing Address - Fax:
Practice Address - Street 1:5985 DUBLIN BLVD, UNIT 110
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923
Practice Address - Country:US
Practice Address - Phone:719-359-8295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty