| NPI | 1053030288 |
|---|---|
| Doing Business As | PREMIER DENTAL OF EVERGREEN |
| Entity Type | Organization |
| Authorized Contact | MATTHEW A BUNCHMAN CEO 303-679-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2022-08-23 |