Provider Demographics
NPI:1962642256
Name:HE DENTTECH, PLLC
Entity Type:Organization
Organization Name:HE DENTTECH, PLLC
Other - Org Name:BRIARGATE DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:BAUMGARDNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:719-487-8961
Mailing Address - Street 1:2376 RUSTY RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-2086
Mailing Address - Country:US
Mailing Address - Phone:719-487-8961
Mailing Address - Fax:
Practice Address - Street 1:7750 N UNION BLVD
Practice Address - Street 2:STE.101
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-4051
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:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8566122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty