| NPI | 1386162329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE OLSON Regional Human Resource Director 719-375-1358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 202298) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2018-03-17 |