| NPI | 1396071643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH J. PENN Office Manager 303-773-8262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 8725) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO 8734) |
| Enumeration Date | 2009-10-21 |
| Last Update Date | 2009-10-26 |