| NPI | 1144540444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONJA CRONKHITE Insurance Coordinator 970-523-6333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 9143) |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2020-12-30 |