| NPI | 1174876288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE K ARBUCKLE Credentialing Specialist 303-285-6098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 6097) |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2012-10-26 |