| NPI | 1518482199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH RICARDO REYNOLDS Oral And Facial Surgeon 970-663-6878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CO 7908) |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2017-08-04 |