| NPI | 1285905810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA JOHNSON Vice President 303-779-1305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 9613) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 9614) |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2012-01-12 |