| NPI | 1194269787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER BUMGARNER Owner 303-495-2801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CO 0334) |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2016-12-15 |