| NPI | 1316292097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLIS JOHNSON Dentist Owner 303-322-1177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO 104176) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CO 105493) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2012-07-18 |