| NPI | 1104186501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLIS JOHNSON Owner/Dentist 303-322-1177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: CO 104176) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2012-05-21 |