NPI | 1508023805 |
---|---|
Entity Type | Organization |
Authorized Contact | CASEY W JOHNSON Partner 970-928-9500 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2008-05-22 |
Last Update Date | 2024-01-11 |