| NPI | 1518782788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA HART Owner/Operations Manager 719-582-5957 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 124Q00000X Dental Hygienist |
| Enumeration Date | 2024-11-21 |
| Last Update Date | 2024-12-02 |