| NPI | 1104273622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SHIFMAN Clinical Director 720-520-2053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN.00010381) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00010381) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CO DEN.00010381) | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2016-05-16 |