Provider Demographics
NPI:1245856244
Name:AURORA FAMILY DENTISTRY LLC
Entity type:Organization
Organization Name:AURORA FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:SHELDRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-238-2977
Mailing Address - Street 1:13700 E COLFAX AVE UNIT M
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-6847
Mailing Address - Country:US
Mailing Address - Phone:303-364-4322
Mailing Address - Fax:303-577-0190
Practice Address - Street 1:13700 E COLFAX AVE UNIT M
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-6847
Practice Address - Country:US
Practice Address - Phone:303-364-4322
Practice Address - Fax:303-577-0190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-25
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty