| NPI | 1144516592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA L. SKINNER Dentist 719-566-0206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 9998) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2011-06-23 |