| NPI | 1467828905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK STEPHEN OWENS Owner 303-349-6480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 0020124) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |