| NPI | 1235398934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE ALAN TILLISS Owner/Dentist 303-779-6924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CO 104295) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2008-06-06 |