| NPI | 1508368093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN SMITH President Of Operations 719-322-4949 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CO 8290) |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2018-03-01 |