| NPI | 1023589181 |
|---|---|
| Doing Business As | BASALT DENTISTRY, PC |
| Entity Type | Organization |
| Authorized Contact | JONATHAN JAMES HAERTER Dentist/Owner 970-376-4769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2019-04-29 |