| NPI | 1114166865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLTON FLAKE President 720-277-5930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 10630) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: CO 10630) | |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2023-09-25 |