| NPI | 1205028941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE PACHECO Business Manager 719-392-5111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 8170) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2026-01-15 |