| NPI | 1326673880 |
|---|---|
| Doing Business As | EAGLERIDGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | CHARLES WOHLWEND Owner/Dentist 719-542-1212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2020-03-05 |
| Last Update Date | 2020-03-05 |