| NPI | 1316155369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE MATTHEW ERICKSON President And Owner 719-539-7655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 8677) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |