NPI | 1497928527 |
---|---|
Entity Type | Organization |
Authorized Contact | RUSTY KIP DAVIS President 303-364-6455 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO 9535) |
Enumeration Date | 2008-04-09 |
Last Update Date | 2008-04-09 |