NPI | 1316618119 |
---|---|
Entity Type | Organization |
Authorized Contact | ALICE KANIFF Owner 970-319-2999 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Enumeration Date | 2021-09-22 |
Last Update Date | 2021-09-22 |