| NPI | 1518264225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK JOSEPH BENTELE President 719-268-7138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CO 9140) |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2011-02-15 |