| NPI | 1376833889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN RICHARD NELSON Owner 303-758-6850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CO 6819) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2011-04-18 |