| NPI | 1194118570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRE M GILLESPIE Owner 720-436-1303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 00202397) |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2021-09-22 |