| NPI | 1336576206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY BRUCE RESNICK Owner/Orthodontist 970-945-8525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 106353) |
| Enumeration Date | 2013-10-08 |
| Last Update Date | 2013-10-08 |