| NPI | 1427233212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE A PENNER Office Manager 719-597-0038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: CO 8936) |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2008-07-15 |