| NPI | 1114515350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER BUMGARNER Owner 303-495-2801 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-01-04 |
| Last Update Date | 2021-01-04 |