| NPI | 1124466727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE IRWIN RICHARD Owner Dentist 303-204-6339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 9697) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 9903) |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2013-06-05 |