| NPI | 1477746105 |
|---|---|
| Doing Business As | I D DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | PEGGY J BURNETTE Chief Financial Officer 303-602-4964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: CO 010444) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2015-12-28 |