| NPI | 1346321163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A. REINICKE Dentist 719-634-5864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 7270) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-08-22 |