| NPI | 1366975765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE LEOS Practice Administrator 303-772-8870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CO DEN.00010071) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: CO DEN.00201841) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2017-04-04 |