| NPI | 1013256718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY DONALD O'NEAL Dentist 719-599-5340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 6086) |
| Enumeration Date | 2013-01-31 |
| Last Update Date | 2013-01-31 |