| NPI | 1124769526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAYLEE GRIFFIN Owner 970-824-9408 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2022-08-18 |