| NPI | 1306264262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERREN TIPPETS Dentist / Owner 970-240-8694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 9579) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2014-03-28 |