| NPI | 1144498999 |
|---|---|
| Doing Business As | PEDIATRIC DENTISTRY OF THE ROCKIES |
| Entity Type | Organization |
| Authorized Contact | KEITH ALLEN VAN TASSELL President/Owner 970-484-4104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 9197) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2018-10-23 |