| NPI | 1225403991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WILLIAM BULL Sole Proprietor 970-243-2855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO DEN00000167) |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2015-12-07 |