| NPI | 1124107024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER S WELCH Owner 719-587-0207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 6608) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 460) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2020-08-22 |