| NPI | 1063610269 |
|---|---|
| Doing Business As | PAGOSA SMILES |
| Entity Type | Organization |
| Authorized Contact | JACK GLENN RUTHERFORD President 970-731-3627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 6065) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2007-07-10 |