| NPI | 1083421721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLANCA RICHARDSON Hr Manager 970-223-8687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-12-16 |
| Last Update Date | 2024-12-16 |