| NPI | 1427360254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFFER RENEE MARTINEZ Office Manager 719-591-1811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 9850) |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2010-07-09 |