Provider Demographics
NPI:1992390025
Name:BRIGHTON RESTORATIVE DENTISTRY PLLC
Entity Type:Organization
Organization Name:BRIGHTON RESTORATIVE DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROSTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:GOGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-427-4120
Mailing Address - Street 1:2700 E BRIDGE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-2561
Mailing Address - Country:US
Mailing Address - Phone:303-659-1825
Mailing Address - Fax:
Practice Address - Street 1:2700 E BRIDGE ST STE 101
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-2561
Practice Address - Country:US
Practice Address - Phone:303-659-1825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty