| NPI | 1326343153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED ALAN WARD President 970-672-8218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 10348) |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2015-11-03 |