| NPI | 1265851042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEUNG LEE Owner 303-577-0377 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 7478) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 9056) |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2014-04-09 |