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 |