| NPI | 1063959161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE A SCOTT Financial Administrator 719-545-2722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2017-01-26 |