NPI | 1457774168 |
---|---|
Entity Type | Organization |
Authorized Contact | ENA MARIE MILLICH Owner 970-563-0373 |
Organization Subpart ? | No |
Primary Taxonomy | 124Q00000X Dental Hygienist |
Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: CO 2023390) |
Enumeration Date | 2014-01-31 |
Last Update Date | 2020-07-17 |