| NPI | 1437906435 |
|---|---|
| Doing Business As | POUDRE VALLEY FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | RICHARD GRAY President 970-221-3020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-05-06 |
| Last Update Date | 2024-05-06 |