| NPI | 1366960775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYSON PECHEK Director Of Dentistry 719-821-2237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 9163) |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2017-10-10 |