| NPI | 1063534642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL K ROLLERT Owner 303-798-2208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CO 7699) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2008-03-21 |