| NPI | 1134493083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGDALENA EVANS Sr Credentialing Specialist 720-603-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2012-02-23 |
| Last Update Date | 2024-10-14 |