| NPI | 1295089563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELVIN DE JULIO Office Manager 303-309-0369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CO 9692) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2012-11-07 |