| NPI | 1407350390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE RICHMOND Owner/Provider 303-322-1177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN.00203018) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-03-23 |