| NPI | 1346484193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE M CORONA Office Manager 303-431-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CO 0796) |
| Additional Taxonomies | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: CO 0796) |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2009-04-23 |