| NPI | 1497174155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES E BEARD Member 773-383-3878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CO DEN.00202129) |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2014-04-09 |