| NPI | 1235536046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIKASH KANCHANLAL President 719-287-0807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CO 8392) |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2014-11-21 |