| NPI | 1184612087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCARLET DISSE-PFEIFER Owner/Dentist 303-850-7614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 105359) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 5440) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2020-08-22 |