| NPI | 1073042370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA LYNN SHAVER Owner/Orthdontist 303-751-1313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 7280) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-07-21 |