| NPI | 1518351691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BREANN ALBER-MOEN Office Manager 970-226-6443 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 8446) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO 9962) |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2015-03-26 |