| NPI | 1285980532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA TOBIN Front Office 970-241-4937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 10234) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2020-12-07 |