| NPI | 1053727024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH K MCCOMBS Doctor 719-368-0950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CO DEN.00202187) |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2014-07-10 |