| NPI | 1518744416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ROLLERT Dentist/Owner 303-503-5039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2023-09-13 |
| Last Update Date | 2023-09-13 |