| NPI | 1376142000 |
|---|---|
| Doing Business As | NORTHEASTERN DENTAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | CARY LACOUTURE Owner 303-521-5701 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-10-23 |
| Last Update Date | 2020-10-23 |