NPI | 1225588221 |
---|---|
Entity Type | Organization |
Authorized Contact | BRIAN J WILLOUGHBY Sole Owner 303-320-5700 |
Organization Subpart ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: CO 40115) |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
Enumeration Date | 2016-10-13 |
Last Update Date | 2016-10-13 |