| NPI | 1386231868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONJA CRONKHITE Insurance Coordinator 970-523-6333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-12-30 |
| Last Update Date | 2020-12-31 |