| NPI | 1205028941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM MONTANO 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 | 2018-05-30 |