| NPI | 1295811602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE M GILLIS President 970-242-3635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 6642) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2015-06-03 |