| NPI | 1215240882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN MILLER Office Administrator 303-321-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: CO CO-104214) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CO CO-7149) |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2010-07-23 |