| NPI | 1144078684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIONA MOTUFAU Dentist 970-712-1463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| Enumeration Date | 2024-05-09 |
| Last Update Date | 2024-05-09 |