| NPI | 1245443902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | W JOHN MATTHEWS Dmd Dentist 719-598-0907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO 248) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |