| NPI | 1316449523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK CHESTNUT Owner/President 303-955-8490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CO 202597) |
| Enumeration Date | 2018-03-03 |
| Last Update Date | 2018-03-03 |