| NPI | 1215697073 | 
|---|---|
| Doing Business As | ENHANCE DENTAL | 
| Entity Type | Organization | 
| Authorized Contact | GREGORY KOSTELAC Credentialing Specialist 719-372-5605 | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice | 
| Enumeration Date | 2021-12-21 | 
| Last Update Date | 2021-12-21 |