Provider Demographics
NPI:1053142547
Name:BRIGHTON GRIN ORTHO, PLLC
Entity type:Organization
Organization Name:BRIGHTON GRIN ORTHO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:COLTON
Authorized Official - Middle Name:
Authorized Official - Last Name:FLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-659-7700
Mailing Address - Street 1:7999 S COUNTRY CLUB PKWY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-1195
Mailing Address - Country:US
Mailing Address - Phone:720-579-8855
Mailing Address - Fax:877-444-4055
Practice Address - Street 1:2700 E BRIDGE ST STE 201
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:303-659-7700
Practice Address - Fax:303-330-0714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty