| NPI | 1255706115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MCDILL Memeber 970-484-5297 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 8319) |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2015-12-03 |