| NPI | 1225447709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGGI EVANS Sr. Credentialing Specialist 720-272-7558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OH 30019501) |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2025-02-28 |