| NPI | 1316129570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID O JACOBSON President 970-257-7474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 8802) |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2007-11-29 |