| NPI | 1053637769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVETTE MADRIGAL Office Manager 303-462-1462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CO 7680) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CO 6889) |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CO 9224) | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CO 9257) | |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2011-06-14 |