| NPI | 1104130293 |
|---|---|
| Doing Business As | BOULDER MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | WILLIAM J MCGLASHAN Contracts Admin 303-442-4455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2010-07-30 |
| Last Update Date | 2010-07-30 |