| NPI | 1396097143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN F OLSEN Owner 303-870-7221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 358375-9922) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO 9149) |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2012-10-03 |