| NPI | 1255188322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE WRIGHT Owner 970-888-4465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics |
| Additional Taxonomies | 1223E0200X Dentist Endodontics |
| 1223P0700X Dentist Prosthodontics | |
| Enumeration Date | 2024-05-06 |
| Last Update Date | 2024-05-06 |