| NPI | 1114111713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL A. ISRAELSON Owner 303-666-4499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 8638) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2007-08-28 |