| NPI | 1467718155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN R DEAN President 970-255-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 104423) |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2012-04-06 |