| NPI | 1518340694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK DEAN Dentist 970-261-3004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2015-07-07 |