| NPI | 1356852214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW T JORGENSEN Owner 720-289-7001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Additional Taxonomies | 292200000X Dental Laboratory |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2017-10-18 |