Provider Demographics
NPI:1679312706
Name:MAIRS FAMILY DENTISTRY PC
Entity type:Organization
Organization Name:MAIRS FAMILY DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAIRS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-420-3310
Mailing Address - Street 1:6355 WARD RD UNIT 201
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-3822
Mailing Address - Country:US
Mailing Address - Phone:303-420-3310
Mailing Address - Fax:
Practice Address - Street 1:6355 WARD RD UNIT 201
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-3822
Practice Address - Country:US
Practice Address - Phone:303-420-3310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies