NPI | 1003058116 |
---|---|
Entity Type | Organization |
Authorized Contact | RACHEL PACKER Owner/President 303-286-4382 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 8499) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 8466) |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 105855) | |
Enumeration Date | 2009-04-03 |
Last Update Date | 2009-04-03 |