| NPI | 1053589309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE C. PETTYJOHN President 303-791-9141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 9000) |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2008-02-20 |