| NPI | 1417320623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE KAY ARBUCKLE Credentialing Manager 303-285-6098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 5496) |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2015-11-10 |