| NPI | 1467100412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN JAMES SIEDOW Manager / Dental Director 720-933-2372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 122300000X Dentist |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2022-03-17 |
| Last Update Date | 2022-08-30 |