| NPI | 1013504927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON BERGLOFF Admin 720-431-6060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics |
| Additional Taxonomies | 1223P0300X Dentist Periodontics |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2020-12-26 |
| Last Update Date | 2020-12-26 |