| NPI | 1508291659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE LYNNE REED Dental Hygiene 970-964-4546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CO 904695) |
| Enumeration Date | 2013-09-09 |
| Last Update Date | 2013-09-09 |